News Briefs: Week of June 14-18

This roundup includes the following news briefs:

Merck & Co. Inc. and GlaxoSmithKline Biologicals have revised the prescribing information and package labeling for their respective live rotavirus vaccines after reported cases of vaccine-acquired rotavirus infection in infants with severe combined immunodeficiency, or SCID.

Merck manufactures a pentavalent rotavirus vaccine, RotaTeq; GlaxoSmithKline manufactures a monovalent vaccine, Rotarix.

The CDC said in the June 11 Morbidity and Mortality Weekly Report that the agency has updated the list of contraindications for rotavirus vaccine to include infants diagnosed with SCID, which includes a group of rare, life-threatening disorders that are caused by more than a dozen single-gene defects and that result in profound deficiencies in T- and B-lymphocyte function.

The CDC estimated the annual incidence of SCID at one case per 40,000-100,000 live births, or 40,100 new cases among U.S. infants each year. Infants with SCID commonly experience chronic diarrhea, failure to thrive and early onset of infections. Diagnosis and hematopoietic stem cell transplantation before onset of severe infections offer the best chance for long-term survival, the agency said.

The median age at diagnosis of SCID is 4-7 months, which overlaps with the ages for recommended rotavirus vaccination (1-page PDF; About PDFs).

HHS approved the addition of SCID to the uniform screening panel for newborns in May.

HHS recently released information about a $25 million grant initiative project aimed at helping states and health systems implement and evaluate patient safety and medical liability reforms. The agency awarded $23 million to 20 grant recipients across the country; another $2 million was allocated for a final evaluation contract.

According to June 11 press release from HHS, demonstration projects supported by the grants will test models that do one of four things: work to reduce preventable injuries; foster better communication between physicians and patients; ensure that patients who sustain medical injuries are compensated in a fair and timely manner, while also reducing the number of frivolous lawsuits; and reduce liability premiums.

HHS Secretary Kathleen Sebelius called the new research "the largest government investment connecting medical liability to quality." She said the research would improve the overall quality of health care in the United States. Details on each demonstration project are available through the Agency for Healthcare Research and Quality.

A study in the June issue of Pediatrics has linked exposure to organophosphate pesticides to attention-deficit/hyperactivity disorder, or ADHD, in children.

In a study of 1,139 children, 119 -- or 12 percent -- met the diagnostic criteria for any ADHD subtype. Children with high urinary dialkyl phosphate concentrations, especially dimethyl alkylphosphate, or DMAP, concentrations, were more likely to be diagnosed with ADHD. Researchers found that a 10-fold increase in DMAP concentration was associated with an odds ratio for any ADHD subtype of 1.55 after adjustment for other factors.

More than 70 million pounds of organophosphates are used each year in U.S. agricultural and residential settings. Food, drinking water and residential pesticide use are important sources of exposure, but the leading source of exposure for infants and children is diet, according to the study.

Researchers said their study supports the hypothesis that current levels of organophosphate pesticide exposure might contribute to the childhood burden of ADHD, but they acknowledged that prospective studies are needed to establish whether the association is causal.

The Medicare Payment Advisory Commission, or MedPAC, has submitted a report to Congress that explains how graduate medical education, or GME, financing in the Medicare program could be changed to improve the provision of primary care services.

In its June report, Aligning Incentives in Medicare (287-page PDFs; About PDFs), MedPAC makes a set of recommendations to Congress on how to change Medicare's financing of GME to align it with MedPAC's broader goal of delivery system reform. For example, the commission recommends that a significant portion of Medicare's GME payments be contingent on residency programs meeting key education criteria, such as teaching team-based care, training in ambulatory settings and measuring quality.

A patient-centered medical home education pilot project in Ohio will focus on converting 44 practices to the patient-centered medical home, or PCMH, model of care, according to House Bill 198, which was signed into law recently by Gov. Ted Strickland.

Forty of those practices will be led by physicians and four by advanced-practice nurses. The physician-led practices must be affiliated with the Wright State University Boonshoft School of Medicine in Dayton, the University of Toledo College of Medicine, the Northeastern Ohio Universities Colleges of Medicine and Pharmacy in Rootstown, or the Ohio University College of Osteopathic Medicine in Athens.

In addition, the deans of the Ohio medical schools will develop a proposal to create as many as 50 scholarships each year for medical students who participate in PCMH training and agree to practice primary care for at least three years in Ohio after residency.

The Center for the History of Family Medicine, or CHFM, has obtained a significant new donation in the form of the papers of G. Gayle Stephens, M.D.

Stephens founded the Family Practice Residency Program at Wesley Hospital in Wichita, Kan., in 1967 and served as its director until 1972. That residency program was one of the first 15 family practice residency programs (1-page PDF; About PDFs) in the nation to be approved by the Residency Review Committee in 1968 under the Essentials for Approved Residencies in Family Practice.

In 1973, Stephens was named the founding dean of the School of Primary Medical Care at the University of Alabama in Huntsville. He also served as president of the Society of Teachers of Family Medicine from 1973-75.

From 1977 until his retirement in 1988, Stephens was professor and chair of the Department of Family Practice at the University of Alabama in Birmingham, where he now is Professor Emeritus of Family Medicine.

Housed at AAFP headquarters in Leawood, Kan., and administered by the AAFP Foundation, the CHFM serves as the principal resource center for the collection, conservation, exhibition and study of materials relating to the history of family medicine.