New article in J. of General Internal Medicine calls for simplifying EHRs
At my January 31, 2018 Healthcare Renewal blog post "The inevitable downgrading of burdensome, destructive EHRs back to paper&document imaging" athttp://hcrenewal.blogspot.com/2018/01/the-inevitable-downgrading-of.html, I opined that the downgrading of the clinician-facing components of EHRs was essential and inevitable. A new editorial in the Journal of General Internal Medicine makes similar points:Electronic Health Records: a " Quadruple Win, " a " Quadruple Failure, " or Simply Time for a Reboot?Journal of General Internal MedicineMichael Hochman05 February 2018https://link.springer.com/article/10.1007%2Fs11606-018-4337-6 "Perhaps most importantly, there must be a dramatic and thoughtful simplification of EHR documentation templates: it should not take over 200 mouse clicks and more than 700 key strokes to complete one ambulatory encounter. "Indeed.And this statement, seen frequently at this site, also appears:" Put simply, EHRs must be redesigned around the needs of clinicians and patients rather than billers and administrators. "The article also makes many other points about the technology I've been writing about for decades, such as the now-obvious grossly exaggerated claims about benefits and cost savings, and others:... many of the predictions about the benefits of EHRs have yet to materialize to the extent predicted. Though EHRs have facilitated some substantial improvements —the ability for cl...
Women are twice as likely to develop severe depressive symptoms after stroke compared with their male counterparts, new research shows.Medscape Medical News
Kars C. J. Compagne, R. B. Goldhoorn, Maarten Uyttenboogaart, Robert J. van Oostenbrugge, Wim H. van Zwam, Pieter J. van Doormaal, Diederik W. J. Dippel, Aad van der Lugt, Bart J. Emmer, Adriaan C. G. M. van Es, the MR CLEAN investigators
Yanna Tong, Zhe Cheng, Gary B. Rajah, Honglian Duan, Lipeng Cai, Nan Zhang, Huishan Du, Xiaokun Geng, Yuchuan Ding
Authors: Vaturi M, Lev EI Abstract PMID: 30772964 [PubMed - in process]
CONCLUSIONS: Ultrasound-guided botulinum toxin injections into the parotid and submandibular glands seem to be a safe and effective therapy for the treatment of drooling. Further long-term prospective studies with varying doses are warranted. PMID: 30772963 [PubMed - in process]
Authors: Blum A, Pastukh N, Sirchan R, Blum N, Chernikoff L, Vaispapir V Abstract BACKGROUND: Endothelial progenitor cells may have a role in ongoing endothelial repair. Impaired mobilization or depletion of these cells may contribute to progression of vascular disease. Our hypothesis was that endothelial progenitor cells would be suppressed in patients with acute cerebrovascular event based on our previous study that found severe endothelial dysfunction in those patients. OBJECTIVES: To study the ability of patients with acute stroke to build colonies of endothelial progenitor cells. METHODS: We studied th...
This report explains the potential interaction between warfarin and astaxanthin in a 69-year-old Thai woman with history of ischemic stroke. Before taking astaxanthin, the patient used constant doses of warfarin, atenolol, digoxin, aspirin, omeprazole, and simvastatin concomitantly for 17 days without any signs and symptoms of adverse events. One day after astaxanthin was supplemented to her treatment regimen, ecchymosis was found on the right side of her groin and thigh. On the next day, area of ecchymosis was larger. International normalized ratio (INR) values increased from 1.4 to 10.38. Warfarin and astaxanthin were wi...
ConclusionThe present study revealed a significant number of ECG findings during continued ECG monitoring for AF in patients with cryptogenic stroke. Apart from AF (17.5% during the first 1.5 years), other clinical relevant arrhythmias requiring, e.g., pacemaker implantations, were observed. With respect to these findings, we recommend to extend ILR monitoring to the end of battery life. However, acceptance of continued ECG monitoring until battery depletion was poor; in 71 patients (6 4%), the ILR were explanted before the end of battery life.Trial registrationRegistered at ClinicalTrials.gov: NCT02641678.
Condition: Stroke Interventions: Other: virtual reality; Other: robotic gait Sponsor: Hacettepe University Recruiting
Conditions: Left Hemispheric Stroke, Subacute Phase; Left Hemispheric Stroke, Chronic Phase Intervention: Diagnostic Test: Perfusion functional Magnetic Resonance Imaging (perfusion fMRI) Sponsors: Kessler Foundation; Rutgers University; National Center for Medical Rehabilitation Research (NCMRR) Recruiting