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Warren Buffett Compares Cost of Healthcare in the U.S. to a Corporate Tax
Warren Buffett was quoted in a recent article as comparing the cost of healthcare in the U.S. to a corporate tax (see:Forget Taxes, Warren Buffett Says. The Real Problem Is Health Care). This line of reasoning is important because many executives are lobbying the administration for a lower corporate tax rate. Buffett thinks that they should more appropriately be seeking a lower cost of healthcare in order to be able to operate more competitive globally. I think that he's right and we need a broader discussion of this topic. Below is an excerpt from the art...
Source: Lab Soft News - May 22, 2017 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Cost of Healthcare Direct Access Testing (DAT) Healthcare Delivery Healthcare Insurance Lab Industry Trends Lab Regulation Medical Consumerism Medical Research Source Type: blogs

Being mindful about mindfulness
I’m generally a supporter of mindfulness practice. It’s been a great discipline for me as I deal with everyday life and everything. I don’t admit to being incredibly disciplined about “making time for meditation” every day – that is, I don’t sit down and do the whole thing at a set time each day – but I do dip in and out of mindfulness throughout my day. While I’m brushing my teeth, slurping on a coffee, driving, sitting in the sun, looking at the leaves on the trees, cuddling my Sheba-dog I’ll bring myself to the present moment and take a couple of minutes to be ...
Source: HealthSkills Weblog - May 21, 2017 Category: Anesthesiology Authors: adiemusfree Tags: Chronic pain Clinical reasoning Pain conditions Relaxation Resilience/Health Science in practice acceptance mindfulness persistent pain willingness Source Type: blogs

Mandate
A few weeks ago I was awakened by a 2 a.m. call from the ED regarding a case of pneumoperitoneum. I barely recall the specifics of the conversation, but I vaguely remember snippets of phrases, words that light the fires and compel immediate action: "free air, tender all over, hypotension". I donned some old scrubs and quickly drove in to the hospital.The patient wasn't much older than me. He looked healthy, had a robust build. No other medical problems. But his vitals were perilously unstable. Heart rate 120's. Blood pressure 70 systolic despite several liters of fluid. The...
Source: Buckeye Surgeon - May 21, 2017 Category: Surgery Authors: Jeffrey Parks MD FACS Source Type: blogs

Even short-term opioid use can set people up for addiction risks | Science News
Even though a sprained ankle rarely needs an opioid, a new study of emergency room patients found that about 7 percent of patients got sent home with a prescription for the potentially addictive painkiller anyway. And the more pills prescribed, the greater the chance the prescription would be refilled, raising concerns about continued use.The research adds to evidence that it's hard for some people to stop taking the pills even after a brief use. State officials in New Jersey recently enacted a law limiting first-time prescriptions to a five-day supply, and other states should consider similar restrictions, says Ki...
Source: Psychology of Pain - May 20, 2017 Category: Anesthesiology Source Type: blogs

Non-Contact Respiratory Rate Sensor Built Into a Cotton T-Shirt
At the Université Laval in Quebec City, Canada, researchers have developed a respiration sensor built into a t-shirt that can be sampled by a nearby radio device. The idea is that patients in a hospital would wear a lightweight, comfortable shirt that doesn’t have any wires, while their breathing rate would be discreetly monitored in real-time. The sensor itself is simply a spiral antenna made out of multi-material fibers. It’s embedded into the fabric of a common cotton t-shirt so that the expansion of the chest on every breath causes the antenna to bend slightly. This change in the geometry o...
Source: Medgadget - May 19, 2017 Category: Medical Devices Authors: Editors Tags: Anesthesiology Critical Care Diagnostics Medicine Pediatrics Surgery Source Type: blogs

BrainCool ’s IQool Patient Cooling System Cleared in U.S.
BrainCool, a company based in Lund, Sweden, landed FDA clearance to introduce its IQool patient cooling system. Pads filled with BrainCool’s “BCCOOL” non-toxic liquid are placed around the patient’s head and neck, thighs, and the torso, and a programmable chiller cools and moves the liquid through the pads. The pads don’t have any adhesive material on them, but instead mold around the patient to create firm contact. They come pre-filled and are essentially plug-and-play. They can operate independently or as a team, allowing for applicability with different procedures. The company is touting th...
Source: Medgadget - May 18, 2017 Category: Medical Devices Authors: Editors Tags: Anesthesiology Cardiology Critical Care Medicine Neurology Neurosurgery Source Type: blogs

Becoming a millennial mother: 3 tips for labor and delivery
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Expecting a baby? Congratulations! Giving birth today is not the same as when your mother gave birth. You have new options and different choices to make. You will recover faster than even before, and your participation will be requested. Ready? Let’s talk about three tips that will help you to power through the labor and delivery process. 1. Help me help you. You may not know it, but I’m your guardian angel during your labor and post-delivery experience.  As a physician anesthesiologist specializing in obs...
Source: Kevin, M.D. - Medical Weblog - May 14, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/mark-zakowski" rel="tag" > Mark Zakowski, MD < /a > Tags: Conditions OB/GYN Source Type: blogs

“ Beholders ” or patients and families?
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog This is a guest post by Dr Peter Hutchinson, Professor of Neurosurgery; Dr Angelos Kolias, Clinical Lecturer in Neurosurgery; and Dr David Menon, Professor of Anaesthesia – all at the University of Cambridge and Addenbrooke’s Hospital, Cambridge, UK. It is a response to the recent LITFL post by Dr Alistair Nichol titled RESCUEicp and the Eye of the Beholder. * beholder NOUN literary, archaic  A person who sees or observes someone or something. We...
Source: Life in the Fast Lane - May 14, 2017 Category: Emergency Medicine Authors: Chris Nickson Tags: Intensive Care Neurosurgery angelos kolias david menon Decompressive craniectomy peter hutchinson RESCUEicp TBI traumatic brain injury Source Type: blogs

When patients personally know their anesthesiologist
One of the things I most enjoy about being an anesthesiologist is the wide variety of patients that I see. You never know who you’re going to have the privilege to care for on a given day. Although my group is large, I will occasionally be assigned to a patient that I personally know. And occasionally, someone I know will request me as their anesthesiologist. Last month I took care of a friend who requested me for her surgery. It was a very straightforward case, everything went smoothly, and she expressed abundant gratitude at the end of her experience. I was also asked to do anesthesia by a friend for a surgery that...
Source: Kevin, M.D. - Medical Weblog - May 13, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/dawn-baker" rel="tag" > Dawn Baker, MD, MS < /a > Tags: Physician Surgery Source Type: blogs

Pain in Animals Workshop 2017 – Creating a Research Roadmap for measuring chronic pain in dogs and cats
Despite recent advances, chronic pain is one of the most poorly understood, under diagnosed, and under treated medical problems facing veterinary medicine today. One of the most frustrating parts of chronic pain therapeutic development in veterinary medicine is the lack of validated methods to measure chronic pain in different species and diseases.In parallel, translational success has come under the spotlight. Numerous reviews have highlighted a lack of translation of basic research into new approved therapeutics for treatment of persistent pain in humans. The use of spontaneous painful disease in companion animals has be...
Source: Psychology of Pain - May 13, 2017 Category: Anesthesiology Source Type: blogs

An Open Letter to Audi
Dear Audi, I have been an Audi owner since 1998 when I bought a new Audi A4. Since that A4 I’ve owned an A3, another A3, an S5, and now an A6…..TDI. And that’s where your streak stops. My 2014 A6 TDI is one of the vehicles for which you and Bosch committed fraud in order to get it to pass emission tests here in the United States. Yes, you’re going to fix it. Yes, you’ve already thrown a thousand dollars at me and will surely throw seven to sixteen thousand more. But it doesn’t matter. So, even though I have loved the cars, their interiors, their sound systems, have taken classes to lear...
Source: Waking Up Costs - May 13, 2017 Category: Anesthesiology Authors: Clark Tags: Uncategorized Source Type: blogs

Emergency medicine is a model for unity
How do you define yourself? How do you describe yourself? In the past, I have tried to avoid immediately categorizing myself by my profession. I always agreed with The Little Prince: Grown-ups love figures … When you tell them you’ve made a new friend they never ask you any questions about essential matters. They never say to you “What does his voice sound like? What games does he love best? Does he collect butterflies?” Instead, they demand, “How old is he? How much does he weigh? How much money does his father make?” Only from these figures do they think they have learned anything abo...
Source: Kevin, M.D. - Medical Weblog - May 12, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/edwin-leap" rel="tag" > Edwin Leap, MD < /a > Tags: Physician Emergency Source Type: blogs

The ACTTION –APS–AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions - The Journal of Pain
As a complement to a taxonomy recently developed for chronic pain, the ACTTION public-private partnership with the US Food and Drug Administration, the APS, and the AAPM convened a consensus meeting of experts to develop an acute pain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acute pain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM Acute Pain Taxonomy will include the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Future efforts will co...
Source: Psychology of Pain - May 10, 2017 Category: Anesthesiology Source Type: blogs

Waiting Room Neurology • UCEM
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Last update: May 9, 2017 @ 9:59 am The Utopian College of Emergency for Medicine (UCEM) is devoted to keeping up with the latest evidence, techniques and iOS updates to ensure that waiting room medicine is at the forefront of critical care applied within the adverse environments of war zones, natural disasters and public hospitals. In an effort to combat that most pertinacious of symptoms ‘the chronic headache‘ – UCEM have scoured all the available informat...
Source: Life in the Fast Lane - May 9, 2017 Category: Emergency Medicine Authors: Tom Cassidy Tags: Neurology Utopian Medicine chronic headache iWR SPGB sphenopalatine ganglion block UCEM Waiting Room Medicine Source Type: blogs

A New Approach for Occupational Licensing in Wisconsin
A decade ago an errant pass in a basketball game hit my thumb hard along the nail. After a couple days of intense pain, the thumbnail fell off and then grew back misshapen. It turned out that the injury killed a portion of the nail bed. As afflictions go it is pretty minor, but it is a tad grotesque and makes a few tasks a bit more difficult.An orthopedic surgeon suggested I either opt for surgery —which may not have worked or been covered by insurance—or else have the entire nail permanently removed for aesthetic reasons. I oped to leave it alone and began getting a regular manicure to keep the thumbnail under...
Source: Cato-at-liberty - May 8, 2017 Category: American Health Authors: Ike Brannon Source Type: blogs

The Ketamine Papers: Science, Therapy & Transformation
BY SUNEEL RATAAN The Ketamine Papers serves as an essential window into the rapidly accelerating application of the anesthetic cum party drug ketamine to individuals with disorders such as treatment-resistant depression and post-traumatic stress disorder (PTSD). In addition, the book’s release coincides with other psychedelics, MDMA (aka ‘Ecstasy’) and psilocybin, being cleared for late-phase clinical trials as therapeutic adjuncts for the treatment and – dare we say – cure of those and related disorders, a process that will still take some years. Given what seems to be an increasing explosio...
Source: The Health Care Blog - May 2, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Ecstasy LSD MDMA Psilocybin PTSD Source Type: blogs

Rethinking The United States ’ Military Health System
During Operations Enduring Freedom and Iraqi Freedom (2001 – 2014), the United States’ military health system completely transformed its approach to casualty care, achieving the highest rate of survival from battlefield wounds in the history of warfare. It is one of the most remarkable accomplishments in the history of US medicine. Ironically, the same health care system that worked miracles “down range” in Iraq and Afghanistan faces mounting criticism at home. How can this be? In part, it is because the military health system has two distinctive missions: support combat and humanitarian assistance ...
Source: Health Affairs Blog - April 27, 2017 Category: Health Management Authors: Arthur Kellermann Tags: Costs and Spending Featured Organization and Delivery Population Health Quality American College of Surgeons Department of Veterans Affairs Jonathan Letterman military health care National Defense Authorization Act TRICARE Source Type: blogs

Edwards HemoSphere Hemodynamic Monitoring System Cleared by FDA
Edwards Lifesciences won FDA clearance for its HemoSphere hemodynamics monitoring system. It works with the Swan-Ganz pulmonary artery catheters that can provide flow, pressure and global indicator of oxygen saturation (CCO, RVEF, RVEDV, SVO2), and the Edwards oximetry central venous catheter that in addition to those can continuously monitor central venous oxygen saturation (ScvO2). A touchscreen monitor is used to control the device, which also displays all the readouts. There’s a bunch of choices available as to what to display, depending on the patient being taken care of. There’s live “cock...
Source: Medgadget - April 27, 2017 Category: Medical Equipment Authors: Editors Tags: Anesthesiology Cardiac Surgery Cardiology Critical Care Medicine Source Type: blogs

AXESS Sedation Mask Hopes to Improve Comfort, Delivery of Gases
Accutron, part of Crosstex International, itself part of Cantel Medical based in Hauppauge, NY, recently unveiled its new AXESS nitrous oxide/oxygen nasal sedation mask. The device is designed to optimize comfort, minimize anxiety particularly in children, reduce opportunities for displacement, and allow for easy access to the mouth for dental and orthodontic procedures. It’s lightweight and stays out of the way of the eyes, as well as the nostrils as it doesn’t have any protruding nipples within its interior. It works with a reusable scavenging circuit that sucks up unused gas and recycles it automatically wit...
Source: Medgadget - April 26, 2017 Category: Medical Equipment Authors: Editors Tags: Anesthesiology Dentistry Pediatrics Source Type: blogs

Executioner/Doctor
There was a very badop-ed published in the NY TimesSaturday by the writer/cardiologist, Dr. Sandeep Jauhar. It's called "Why It's OK for Doctors to Participate in Executions" and that pretty much tells you all you need know. If you were to read something online entitled "Why It's OK for Rapists to Babysit Your Child" you would feel the same filthy layer of scum descend upon your skin as I felt when I read Dr Jauhar's inexplicable ode to Doctors of Death.The piece comes on the heels of a recent decision by the good ol' state of Arkansas to execute 8 men on death row over the next 11 days--...
Source: Buckeye Surgeon - April 23, 2017 Category: Surgery Authors: Jeffrey Parks MD FACS Source Type: blogs

A Bioethics View of Executions in Arkansas
by Craig Klugman, Ph.D. This week the state of Arkansas had planned to execute 8 death-row inmates in 4, back-to-back killings using lethal injection over 10 days. The last execution in Arkansas was 12 years ago, so why the sudden rush? As part of the three-drug cocktail used by this state, their supply of midazolam—an anesthetic—is about to expire. If they do not use the drug by the expiration date, then they can’t use it and the company that makes the drug will not sell it to the state for this purpose.… (Source: blog.bioethics.net)
Source: blog.bioethics.net - April 17, 2017 Category: Medical Ethics Authors: Craig Klugman Tags: Ethics Featured Posts Health Regulation & Law Justice Social Justice Arkansas Execution Source Type: blogs

I ’m equal parts doctor, scribe, and mouse jockey
And I don’t love it. When I gained acceptance into medical school, I thought I would one day have one amazing job, or at least one job title where I might get to wear several meaningful hats. I’m a physician anesthesiologist. It’s my duty to play a role in improving the health and the lives of my patients. I studied and trained for many years to have the privilege of understanding the inner workings of the human body, the many ways it can be assaulted by disease, trauma, and time, and ways to combat those ailments to the best of my ability. Continue reading ... Your patients are rating you online: How to...
Source: Kevin, M.D. - Medical Weblog - April 16, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/physician-on-fire" rel="tag" > Physician on FIRE, MD < /a > Tags: Physician Surgery Source Type: blogs

Lions, Tigers, and Bears Can Fit in This CT Scanner
Animals at the Brookfield Zoo in Chicago are getting world-class radiology care. Last summer, La Grange Memorial and Hinsdale hospitals donated their 16-slice CT scanner to the zoo, one of the largest scanners in existence.Both hospitals consolidated their equipment when they moved their imaging services to the Amita Health Cancer Institute& Outpatient Center in Hinsdale, IL. The Brookfield eagerly accepted the new scanner that produces images 16 times faster than their old scanner, thus reducing the amount of time the animal needs to be under anesthesia.The scanner ’s tunnel is 90 centimeters wide, and is suitab...
Source: radRounds - April 13, 2017 Category: Radiology Authors: Julie Morse Source Type: blogs

Learning surgery one stitch at a time
My mind usually starts to wander around the third or fourth hour of retracting a fat flap or holding up a leg during a long operation. I start by guessing how many times the attending has done this particular procedure. Is it his hundredth time doing it? If he was one of the older attendings, perhaps it was his thousandth one. As a neophyte in the operating room, I still relish the chance to scrub in on a case. There’s still a rush of adrenaline when the resident announces,“Incision!” to anesthesia, marking the start of long marathon. Usually the chief resident starts, but it’s the attending who lea...
Source: Kevin, M.D. - Medical Weblog - April 13, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/steven-zhang" rel="tag" > Steven Zhang < /a > Tags: Education Surgery Source Type: blogs

Never underestimate the power of pus
Everyone has their abscess story. Tales of pressurized pockets of pus abound. Trust me: However far-fetched they may seem, they’re not. I had one such experience last week in which a man came to me with a painful red swollen lump on his back. It was about 2 inches in diameter, angry and fluctuant (softened) and ready to be drained, which he pleaded with me to do. So I did. Although this is typically one of the more painful procedures I can inflict on someone, he did great. Possibly his status as a chronic pain patient on a fairly hefty baseline narcotic dose helped. Still, I was able to get away with the “I&rdq...
Source: Kevin, M.D. - Medical Weblog - April 12, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/lucy-hornstein" rel="tag" > Lucy Hornstein, MD < /a > Tags: Physician Primary care Source Type: blogs

Maybe it ’s time for physicians to lean out
A few years ago, my colleagues and I started a non-profit called Women in Anesthesiology.  I started medical school late and had two children in residency (earning the delightful label of elderly primigravida or, if you prefer, geriatric pregnancy). My co-resident and I noticed few women in our department, and even fewer in leadership.  We charged forward, starting a local, then national group.  At the same time, a separate Facebook entity called Physician Anesthesiologist Mom Group (PAMG) grew from a few hundred to over 2,300 members, while the Facebook Physician Moms Group (PMG) skyrocketed to over 63,000....
Source: Kevin, M.D. - Medical Weblog - April 10, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/rekha-chandrabose" rel="tag" > Rekha Chandrabose, MD < /a > Tags: Physician Surgery Source Type: blogs

Pittsburgh Post-Gazette: " Medication errors in hospitals don ’t disappear with new technology " . Government: " It's the doctors' fault. " I am cited.
In conclusion:While I wish the Pittsburgh Post-Gazette article was longer, in its limited space its author did touch upon the major relevant issues well regarding the PA Patient Safety Authority study and its implications towards national Health IT policy.ONC's Dr. Andrew Gettinger's responses, however, seems to reflect an unwillingness of he and the government to acknowledge Bad Health IT.  His repsonses also appear to show a lack of appreciation of the complaints about EMRs from nearly 40 medical societies.  " It's the doctors fault " for not training enough.He does acknowledge that better IT would be...
Source: Health Care Renewal - April 10, 2017 Category: Health Management Tags: Andrew Gettinger MD Donald Rucker Healthcare IT experiment healthcare IT risk ONC Pennsylvania Patient Safety Authority Pittsburgh Post-Gazette Siemens Healthcare Steve Twedt Source Type: blogs

Solution for Difficult Problems: Thumb Dislocation
​Finger dislocations in general are relatively simple to identify and treat, but ligament, tendon, or volar plate injuries are often missed. Thumb dislocations can present with or without lacerations, and are often associated with ligamentous injuries. An injured thumb is almost always treated with splinting. Follow-up for these injuries is crucial. Radiographs are useful in locating the areas of injury and identifying avulsion fractures.Thumb dislocation in a 24-year-old man 12 hours after injury.Listen to the patient's story to identify the mechanism by which the injury occurred because mimicking this mechanism is typi...
Source: The Procedural Pause - March 31, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

The best anesthetic I never gave
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Sometimes our best decisions as physician anesthesiologists are when we decide to call off a surgery or procedure. The “best anesthetic I never gave” was for 18-year-old Hunter Jones and her case really demonstrates the importance of talking with patients before surgery. Hunter was an active, normal high school student enjoying her senior year when she received a colon cancer diagnosis. Both Hunter and her mother were shocked at the diagnosis and surprised again when I had to call off her surgery to remove the cance...
Source: Kevin, M.D. - Medical Weblog - March 31, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mary-herman" rel="tag" > Mary Herman, MD, PhD < /a > Tags: Physician Surgery Source Type: blogs

How to Move Through Anxiety with Greater Ease: A Personal Account
Experiencing anxiety is unpleasant. Unless perhaps you are on line for an amusement park ride, most of us find anxiety challenging to face. Recently I had the opportunity to face some anxiety head on, right before and during some planned surgery that a close family member underwent. Here is a personal experience of how mindfulness helped me through that anxious moment, and what I learned.   What Mindfulness is NOT, and what it CAN offer: While the explosion of research and interest in mindfulness has brought so much benefit to so many, I see as a psychologist that there is now a risk of it being perhaps glamorized and...
Source: World of Psychology - March 30, 2017 Category: Psychiatry & Psychology Authors: Beth Kurland, Ph.D. Tags: Anxiety and Panic Mindfulness Personal Self-Help Stress acceptance crisis fight or flight Loving Kindness nerves nonjudgment overwhelm Panic Attack Present Moment self-compassion surgery Worry Source Type: blogs

Watch who you call “paternalistic”: A physician takes exception to the New York Times
My husband and I, both anesthesiologists, enjoy our Sunday mornings together — coffee, the New York Times, a leisurely breakfast. No rush to arrive in the operating room before many people are even awake. Today, though, seeing reporter Jan Hoffman’s front-page article in the Times — “Staying Awake for Your Surgery?” — was enough to take the sparkle out of the sugar. Her article on how much better it is to be awake than asleep for surgery reminded me why I left a plum job as a reporter for the Wall Street Journal to go to medical school — because reporters have to do a quick, s...
Source: Kevin, M.D. - Medical Weblog - March 27, 2017 Category: Journals (General) Authors: Kevin Tags: Uncategorized Source Type: blogs

Popping Pus
Warning: graphic descriptions ahead. Continue in temporal and/or physical proximity to food and drink at your own risk. Everyone has their abscess story. Tales of pressurized pockets of pus abound. Trust me: however far-fetched they may seem…they’re not. I had one such experience last week in which a man came to me with a painful red swollen lump on his back. It was about 2 inches in diameter, angry and fluctuant (softened) and ready to be drained, which he pleaded with me to do. So I did. Although this is typically one of the more painful procedures I can inflict on someone, he did great. Possibly his status ...
Source: Musings of a Dinosaur - March 23, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs

An open letter to Psychological Medicine, again!
In conclusion, noted Wilshire et al., “the claim that patients can recover as a result of CBT and GET is not justified by the data, and is highly misleading to clinicians and patients considering these treatments.” In short, the PACE trial had null results for recovery, according to the protocol definition selected by the authors themselves. Besides the inflated recovery results reported in Psychological Medicine, the study suffered from a host of other problems, including the following: *In a paradox, the revised recovery thresholds for physical function and fatigue–two of the four recovery mea...
Source: virology blog - March 23, 2017 Category: Virology Authors: Vincent Racaniello Tags: Commentary Information adaptive pacing therapy CFS chronic fatigue syndrome clinical trial cognitive behavior therapy Dave Tuller exercise graded exercise therapy mecfs myalgic encephalomyelitis outcome PACE trial recovery Source Type: blogs

Will telemedicine take your job?
Telemedicine is often in the news and until recently I had only casually glossed over the latest articles. The details I paid little attention to, but the headlines I would remember. “Great for rural areas” I would read! “Extend physician reach!” “Get specialists to greater numbers of patients with unique conditions!” As a nearly graduated anesthesia resident in a large city with an abundance of doctors, I didn’t think telemedicine would have much impact on my future. None of the above headlines applied. However, I would be surprised one morning to wake up to an email that rou...
Source: Kevin, M.D. - Medical Weblog - March 18, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/lifeofamedstudent" rel="tag" > #LifeofaMedStudent < /a > Tags: Physician Hospital Surgery Source Type: blogs

BodyCap e-Celsius Electronic Pill for Core Body Temperature Monitoring
BodyCap, a company based in Caen, France, won the European CE Mark to introduce its e-Celsius swallowable wireless thermometer. Designed to monitor patients’ core temperature, the e-Celsius looks like and is ingested just like a regular drug capsule. As it moves down the GI tract, every 30 seconds the device wirelessly transmits data to an “e-Viewer” that displays the readings and records the temperature during the pill’s journey. During studies, the e-Celsius demonstrated consistency of measurements and the fact that the GI tract has a generally uniform temperature throughout. The readings have mat...
Source: Medgadget - March 13, 2017 Category: Medical Equipment Authors: Editors Tags: Anesthesiology Critical Care Medicine Pediatrics Source Type: blogs

An open letter to Psychological Medicine about “ recovery ” and the PACE trial
In conclusion, noted Wilshire et al., “the claim that patients can recover as a result of CBT and GET is not justified by the data, and is highly misleading to clinicians and patients considering these treatments.” In short, the PACE trial had null results for recovery, according to the protocol definition selected by the authors themselves. Besides the inflated recovery results reported in Psychological Medicine, the study suffered from a host of other problems, including the following: *In a paradox, the revised recovery thresholds for physical function and fatigue–two of the four recovery mea...
Source: virology blog - March 13, 2017 Category: Virology Authors: Vincent Racaniello Tags: Commentary Information adaptive pacing therapy CFS chronic fatigue syndrome clinical trial cognitive behavior therapy Dave Tuller exercise graded exercise therapy mecfs myalgic encephalomyelitis outcome PACE trial recovery Source Type: blogs

Your First Colonoscopy! What to Expect
Whee! Time for a Tube Up Your Tuchus!image:wikimedia commonsBy Crabby McSlackerSo, some perspective here: for people with serious illnesses who've been through hardcore, painful, debilitating, invasive medical procedures? A colonoscopy is probably child's play. (Although let's be clear, that's just an expression. If your child actually plays this way? We need to talk).But for most people, there's at least a little trepidation. And for many, if statistics are to be believed, that fear is significant enough to skip the procedure entirely! Well sure, it could save your life and all, but really? Do you have to?There are actual...
Source: Cranky Fitness - March 12, 2017 Category: Consumer Health News Authors: Crabby McSlacker Source Type: blogs

An Open Briefing For the President ’ s Economic Advisors (And Concerned Members of the House & Senate )
By JOE FLOWER This is a letter I sent to Gary Cohn, appointed by President Trump to head the National Economic Council and, among other things, come up with a plan for reforming healthcare. Formerly president of Goldman Sachs, Cohn may be a wizard at finance, but healthcare economics are wildly different and famously opaque. So I thought I would help him out.] Subject: A brief on healthcare economics. (8 minutes)  o Why healthcare economics are different.  o Why the ACA is failing.  o What would work. Who I am (credentials): Independent healthcare author and analyst since Jimmy Carter’s administration...
Source: The Health Care Blog - March 10, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Why This Doesn ’ t Actually Work The Way You Think It Does
By JOE FLOWER This is a letter I sent to Gary Cohn, appointed by President Trump to head the National Economic Council and, among other things, come up with a plan for reforming healthcare. Formerly president of Goldman Sachs, Cohn may be a wizard at finance, but healthcare economics are wildly different and famously opaque. So I thought I would help him out.] Subject: A brief on healthcare economics. (8 minutes)  o Why healthcare economics are different.  o Why the ACA is failing.  o What would work. Who I am (credentials): Independent healthcare author and analyst since Jimmy Carter’s administration...
Source: The Health Care Blog - March 10, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Healthcare Economics: Why This Stuff Doesn ’ t Actually Work The Way You Think It Does
By JOE FLOWER This is a letter I sent to Gary Cohn, appointed by President Trump to head the National Economic Council and, among other things, come up with a plan for reforming healthcare. Formerly president of Goldman Sachs, Cohn may be a wizard at finance, but healthcare economics are wildly different and famously opaque. So I thought I would help him out.] Subject: A brief on healthcare economics. (8 minutes)  o Why healthcare economics are different.  o Why the ACA is failing.  o What would work. Who I am (credentials): Independent healthcare author and analyst since Jimmy Carter’s administration...
Source: The Health Care Blog - March 10, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

PIVO Gathers Blood Samples from Peripheral IVs, Gets FDA Clearance
Velano Vascular won FDA clearance for its second version of the PIVO needle-free vascular access device. The disposable device helps to gather blood samples from indwelling peripheral IVs, helping to avoid extra needle sticks and not using central lines to draw blood. The PIVO has a catheter that is placed into the peripheral IV and pushed down into the blood vessel, through which blood is pulled back into PIVO’s reservoir. It doesn’t have any needles, reducing the potential for injuries to the staff and repeated needle sticks for the patient, including all the consequences these events can introduce. The ...
Source: Medgadget - March 6, 2017 Category: Medical Equipment Authors: Editors Tags: Anesthesiology Cardiology Critical Care Emergency Medicine Source Type: blogs

LITFL Review 272
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 272nd LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week The Ultrasound podcast have just released a great series on TEE for crashing patients. Here’s...
Source: Life in the Fast Lane - March 5, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

LITFL Review 272
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 272nd LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week The Ultrasound podcast have just released a great series on TEE for crashing patients. Here’s...
Source: Life in the Fast Lane - March 5, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review LITFL R/V Source Type: blogs

Physicians must stop losing their own
In the past few weeks, we have lost two female physician colleagues tragically to suicide, a pediatrician and psychiatrist.  In the general population, males take their lives at four times the rate of females.  However, for physicians specifically, the suicide rate is evenly distributed between genders; making our occupation the one with the highest relative risk for women to die by suicide.  This is what I wish would change about being a female physician; we must stop losing our own. We need to support each other, love one another, and face our challenges together. Fifteen years ago, a surgeon called me in ...
Source: Kevin, M.D. - Medical Weblog - March 5, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/niran-s-al-agba" rel="tag" > Niran S. Al-Agba, MD < /a > Tags: Physician Psychiatry Source Type: blogs

A physician ’s MOC debacle: Nevermind that $2,100 exam he just passed
A couple years ago, I reached the seven-year mark after my initial board certification with the American Board of Anesthesiology (ABA). At the time, it was a significant milestone. I was eligible to take the all-important Maintenance of Certification in Anesthesia (MOCA) exam. Diplomates of the ABA — that’ right, I’m considered a diplomate — in other words, a board-certified anesthesiologist. Diplomates were encouraged and incentivized to take the $2,100 exam early in the three-year eligibility window. The exam was only offered twice a year. There were testing dates during a few weeks in the summer ...
Source: Kevin, M.D. - Medical Weblog - March 5, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/physician-on-fire" rel="tag" > Physician on FIRE, MD < /a > Tags: Physician Surgery Source Type: blogs

Joint Replacement Q & A with Dr. Theodore Manson
Theodore Manson, MD is an Orthopaedic Surgeon at the University of Maryland Medical Center and an Associate Professor of Orthopaedics at the University of Maryland School of Medicine. Dr. Manson specializes in hip and knee replacements and orthopaedic trauma. Below he answers the most common questions about joint replacement.   Q. What advances have there been in joint replacements including new technologies, changes in patient-management and rehabilitation? A. One significant advancement in the last 10 years has been around pain management and early recovery protocols. The goal is to minimize the amount of narcotics...
Source: Life in a Medical Center - March 2, 2017 Category: Universities & Medical Training Authors: Hannah Braun Tags: Doctors Health Tips Orthopaedics Uncategorized Source Type: blogs

A Rare Intervention for an Unusual Exposure
​Children like to put things in their mouth, ears, nose, and eyes. A 9-year-old boy superglued his right eye shut and came to our pediatric emergency department. He thought the glue was an over-the-counter eye lubricant and filled his entire eye with the glue.​​Overdoses and poisonings are a dangerous threat to children. In fact, unintentional poison overdose or ingestion has continued to claim hundreds of children's lives. More than 300 children in the United States ages 0 to 19 are seen at EDs for poisoning and two of them die each year. (CDC. April 28, 2016; http://bit.ly/2kjVmhO.)Not all toxic exposures are inges...
Source: The Procedural Pause - March 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

How Yoga Helps with Depression, Anxiety and Addiction
Aerobic movement of any kind helps to relieve depression and anxiety by boosting our brain’s dopamine levels and providing endorphins. But some types of exercises are superior for healing chronic conditions, mood disorders, and addiction. Yoga’s therapeutic benefits have been studied in recent decades, with much of the research being in randomized controlled trials — the most rigorous for proving efficacy. There are many types of yoga, of course — from the more aerobic power yoga to a meditative gentle yoga. Hatha yoga, the most studied, combines physical postures (asanas) and controlled breath...
Source: World of Psychology - March 1, 2017 Category: Psychiatry & Psychology Authors: Therese J. Borchard Tags: Alcoholism Alternative and Nutritional Supplements Anxiety and Panic Bipolar Depression Exercise & Fitness Mindfulness Personal Self-Esteem Stress Bikram yoga despressive episode Mood Disorder stress reduction Yoga styles Source Type: blogs

A Trick for Ocular Anesthetic​
Watch Helen Karellas Bardis, NP, show off her pediatric pearl! This simple trick works well if you need to use ocular anesthetics for pediatric eye exams.Add a few drops of the saline directly onto the fluorescein paper, and then suck the fluid back up into the saline dropper. This way, you don't have to put a piece of paper onto a child's eye. It is far less scary to have drops administered.This trick also works with tetracaine/proparacaine for an all-in-one staining anesthetic.Watch the video.Tags: ocular anesthetic, eye, fluoresceinPublished: 2/25/2017 10:32:00 AM (Source: The Procedural Pause)
Source: The Procedural Pause - February 25, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Perioperative brain health:  The need to better understand this public health problem
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. During the course of our careers as physicians, we have cared for or are aware of an elderly patient in the intensive care unit or ward who has exhibited delirium, or an acute confused state. This is particularly common after surgery and anesthesia. While simply being in the hospital can lead to delirium, several questions remain. Have best practices and guidelines been fully implemented to decrease this risk? Are clinicians continuing to administer drugs to elderly patients and those with mild cognitive impairme...
Source: Kevin, M.D. - Medical Weblog - February 23, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/lee-a-fleisher-and-roderic-g-eckenhoff" rel="tag" > Lee A. Fleisher, MD and Roderic G. Eckenhoff, MD < /a > Tags: Conditions Neurology Surgery Source Type: blogs