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Fight Aging! Newsletter, August 15th 2016
In conclusion, our results demonstrate that circulating GDF11 levels are reduced in our mouse model of premature aging, which shares most of the symptoms that occur in normal aging. However, GDF11 protein administration is not sufficient to extend longevity in these progeroid mice. Although accelerated-aging mouse models can serve as powerful tools to test and develop anti-aging therapies common to both physiological and pathological aging, the existence of certain differences between the two processes implies that further investigation is still required to determine whether long-term GDF11 administration has a pro-surviva...
Source: Fight Aging! - August 14, 2016 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

An Interview with Noted Pancreas Surgeon Dr. Charles J. Yeo
Recently, InsideSurgery had a chance to speak with Dr. Charles J. Yeo about his career as a top Whipple and pancreas surgeon and his ongoing role as a surgical leader and educator. As the Samuel D. Gross Professor of Surgery and Chair of the Department of Surgery, you welcomed your second intern class to Thomas Jefferson University in Philadelphia, Pennsylvania last month. What one piece advice do you have for your new trainees? One piece of advice….that’s tough! Several pieces of advice….enjoy the challenges and experiences of internship; read and increase your k...
Source: Inside Surgery - August 12, 2016 Category: Surgery Authors: Editor Tags: Interviews Source Type: blogs

A Journalist Once Again Fails to Mention SENS and Rejuvenation when Writing About the State of Longevity Science
The article on longevity science that I'll point out today continues a frustrating recent trend of failing to note one of the most important portions of the aging research field: SENS rejuvenation research. This is a puzzling omission, especially now that senescent cell clearance as a rejuvenation therapy is proven and heading for the clinic - a goal that SENS supporters have been advocating for fifteen years or so. For most journalists, there is no way to quickly and easily distinguish between any of the possible approaches to intervene in the aging process and thus extend healthy life. Being journalists, they are in the ...
Source: Fight Aging! - August 12, 2016 Category: Research Authors: Reason Tags: Activism, Advocacy and Education Source Type: blogs

Uscan Ultrasound for Automatic, High Resolution Bladder Measurements
Signostics out of Bothell, Washington, is releasing its portable Uscan ultrasound system. It consists of a transducer connected to a tablet device, the two optimized to perform urologic visualizations. As the clinician scans the patient, the device takes 256 ultrasound slices to create an outline of the bladder and estimate its volume. This is displayed on the screen, and a number of measurements can be derived from it. The firm believes that unlike the typical eight slices taken by other systems for bladder volume, the Uscan provides a much more accurate result. Additionally the system can be...
Source: Medgadget - August 10, 2016 Category: Medical Equipment Authors: Editors Tags: Anesthesiology Critical Care Surgery Urology Source Type: blogs

Handheld Device Images Children ’s Retinas In High Resolution for First Time
Scientists at Duke University have developed the first device that can be used to reliably image the retinas of young children. While imaging the eyes of adults is routine, children are more challenging because patience and cooperation are a required part of an eye exam. Bulky stationary devices that demand a few minutes of focus are simply not designed for young kids. The Duke team’s handheld probe overcomes many of the limitations of stationary devices while performing scanning laser ophthalmoscopy and optical coherence tomography. Using the device, ophthalmologists are able to visualize the parafoveal photore...
Source: Medgadget - August 9, 2016 Category: Medical Equipment Authors: Editors Tags: Ophthalmology Pediatrics Source Type: blogs

Surprise billing surprises everyone, except the insurance companies
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. In the past several years, there has been a dramatic increase in media attention concerning bills patients receive from health care professionals who are not in the network of providers their insurance company contracted with to provide health services. The out-of-network bills these patients receive have been termed “surprise bills” by the insurance industry, but are also often termed “balance” or “out-of-network” billing. Balance billing occurs when a patient receives a bill for the amount ...
Source: Kevin, M.D. - Medical Weblog - August 8, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/sherif-zaafran" rel="tag" > Sherif Zaafran, MD < /a > Tags: Physician Medicare Source Type: blogs

DM / DNB Cardiology Entrance New Test Series 5
Time limit: 0 Quiz-summary 0 of 30 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Information This new test series requires ...
Source: Cardiophile MD - August 6, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs

Mosquito saliva enhances virus replication and disease
Mosquito saliva, which is injected into the host as a mosquito probes for a blood vessel, contains a collection of chemicals which include anticoagulants to prevent blood clotting, vasodilators to keep blood vessels wide, and anesthetics to prevent us from sensing the mosquito. Saliva also contains components that enhance viral replication, dissemination, and pathogenesis by inducing an inflammatory response that inadvertently promotes infection by providing new cell targets for infection (paper link). To separate the bite from virus inoculation, mice were first exposed to Aedes aegyptii mosquitoes, and then infected ...
Source: virology blog - August 5, 2016 Category: Virology Authors: Vincent Racaniello Tags: Basic virology Information arbovirus Bunyamwera virus dissemination edema inflammation macrophage mosquito neutrophil saliva Semliki Forest virus viral viremia Source Type: blogs

SPRINT Minimally Invasive Peripheral Nerve Stimulator Cleared for Chronic, Acute Pain
SPR Therapeutics out of Cleveland, Ohio received FDA clearance for its SPRINT Peripheral Nerve Stimulation (PNS) System, the first minimally invasive and completely removable peripheral nerve stimulator indicated for chronic and acute pain. The device connects to a coiled electrode lead that is implanted percutaneously and is held in place by a patch for up to thirty days. The neurostimulator itself is about the size of a bandage, and it sends electrical signals toward a target nerve that can be as distant as three centimeters away from the lead tip. The company hopes their device will provide some pati...
Source: Medgadget - August 3, 2016 Category: Medical Equipment Authors: Editors Tags: Anesthesiology Neurology Orthopedic Surgery Pain Source Type: blogs

It ’s time to disrupt basic communications in hospitals. Here’s one idea.
I had just taken over three other residents’ phones and pagers when 2-year-old “Bryce” jumped off the couch in our oncology unit, landed on his chin, and bit completely through his lower lip. I quickly reviewed his platelet level from that morning, examined him, and began calling plastic surgery and anesthesia for sutures. While I was on one phone, a second one started ringing. I declined the call and tried to text back, but immediately the third, and then the fourth phone rang. Assuming somebody was dealing with an emergency, I paused Bryce’s care to take the fifth call. A nurse had wanted to run a...
Source: Kevin, M.D. - Medical Weblog - August 1, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/michael-lee" rel="tag" > Michael Lee, MD, JD < /a > Tags: Tech Health IT Intensive care Source Type: blogs

Just Stop This Blame Rubbish! It Is Totally Clear Who Is To Blame!
I am a specialist anaesthetist. On this nonsense of who is responsible for the gas mess up disaster at a Sydney Hospital it is utterly clear. Some utterly incompetent and utterly guilty person did not check what gas was coming out of each pipe in the Hospital. He/She needs serious jail time. You need (as a clinician) to be utt erly sure what comes out when you open a gas flow - and you can hardly check every time in every place. The engineers need to make this utterly certain and safe or go to jail. Simple! David This is the initial part of the post - read more by clicking on the title of the article. David. (Sourc...
Source: Australian Health Information Technology - August 1, 2016 Category: Information Technology Authors: Dr David More MB PhD FACHI Source Type: blogs

CricSpike to Speed Up Cricothyrotomies on Battlefield and Hospital
Johns Hopkins University is profiling the work of an undergraduate student team that developed a device for performing rapid cricothyrotomies for establishment of an airway, following traumatic battlefield injuries. Explosions are a common threat, often causing injuries that create airway obstructions. Cricothyrotomies are difficult to perform, especially following an attack when nerves are running high. The CricSpike speeds up the process and leaves less room for error thanks to a delivery tip that penetrates the windpipe while preventing entry into the esophagus. The device comes with a large, easy to grab handle that is...
Source: Medgadget - August 1, 2016 Category: Medical Equipment Authors: Editors Tags: Anesthesiology Emergency Medicine Military Medicine Surgery Source Type: blogs

Anorectal Procedures: Thrombosed Hemorrhoids
We are going to get up close and personal this month to talk about hemorrhoids. You should be familiar with these painful offenders because half to two-thirds of people between 45 and 65 will suffer from their cruelty. (Am Surg 2009;75[8]:635.) Patients may seek emergency department care if they experience bleeding or severe pain from hemorrhoids.Hemorrhoids are highly vascular structures that are round or oval in shape. They arise from the rectal and anal canal, and sometimes appear around the anus itself. It is important to note that hemorrhoids do not have arteries and veins but special blood vessels called sinusoids, c...
Source: The Procedural Pause - August 1, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

A medical student delays reporting his needlestick. Here ’s what he learned.
A few months ago, I was on my general surgery rotation on the colorectal service as a medical student. It was in the late afternoon that we started a case of a robotic rectopexy to repair a rectal prolapse. Our patient was a kind and warm 89-year-old woman. The operation finished without a hitch. As we undocked the da Vinci machine, the resident and I began to suture closed the multiple robotic ports on the abdomen. Half-way done with the second port on my side, I felt a pinch on my left index finger as I was locating the suture needle with the driver. I paused briefly to check my gloves. It was only later as I unscrubbed ...
Source: Kevin, M.D. - Medical Weblog - July 24, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Education Medical school Surgery Source Type: blogs

That reminds me: dump Java.
I was just reading a post at MalwareBytes Labs titled Cross-platform Malware Adwind Infects Mac by Thomas Reed about the Adwind Remore Access Tool (RAT) which reminded me I had wanted to remove JAVA from my Mac as it represents a security risk.  A quick DuckDuckGo search led me to How to uninstall Java in Mac OS X at dotTech which offered concise instructions for how to remove both the runtime and the jdk. Go ahead. Do it. You’ll feel smart after using the Terminal. (Source: Waking Up Costs)
Source: Waking Up Costs - July 23, 2016 Category: Anesthesiology Authors: Clark Tags: Security Source Type: blogs

People Post: Staff And Board Changes At Foundations; Job Opening: Foundation President
In June, Becky Hayes Boober left the Maine Health Access Foundation, where she was a senior program officer. She is now vice president of community impact at the Maine Community Foundation (MaineCF) and is working out of its Ellsworth office. She told me in an e-mail, “As part of our strategic planning, we are exploring goals related to health, such as opioid addictions and aging.” MaineCF is refining its new strategic plan, so more information will be forthcoming. Her new boss is Steve Rowe, former president of the Endowment for Health, which is in New Hampshire. I missed it! Nicole Collins Bronzan joined the ...
Source: Health Affairs Blog - July 22, 2016 Category: Health Management Authors: Lee-Lee Prina Tags: GrantWatch Long-term Services and Supports Public Health adolescents Aging Behavioral Health California California Health Care Foundation Centers for Disease Control and Prevention Climate Change culture of health Health Philanthropy Source Type: blogs

Nurse Creates The Mother Lode of All Advance Directives.
Albany, NY -- Adrian Fleming knew all about the horrors that went on at her hospital everyday.  As a seasoned floor nurse at SunnyView Hospital for over 20 years, she had a front seat view of the face palms that threatened patient safety everyday. She also knew someday she would be a patient in her own hospital and with that fear in mind, set out to create the mother lode of all advance directives.An advance directive is a written statement of a person's wishes regarding medical treatment created to ensure those wishes are carried out should the person be unable to communicate them to a doctor.Her advance directi...
Source: The Happy Hospitalist - July 20, 2016 Category: Internal Medicine Authors: Tamer Mahrous Source Type: blogs

Confronting Race Issues in Medicine
As I am writing this, our nation is mourning both the death of several police officers in Dallas, and the end of two more young black men’s lives at the hands of police in Minnesota and Louisiana.  The issues of racial prejudice, racial distrust, and racial profiling and stereotyping affect every aspect of American life and culture, and so medicine is certainly not an exception.  Despite what I would wish, I know that I have racial prejudices, and perhaps at times my patients can sense them. But if medicine in non-unique in its racism, it bears a special responsibility to heal itself so it can best heal oth...
Source: blog.bioethics.net - July 14, 2016 Category: Medical Ethics Authors: Bioethics Today Tags: Health Care syndicated Source Type: blogs

Should AF ablation require approval from a heart team?
A patient presents with atrial fibrillation (AF) and a rapid rate. He doesn’t know he is in AF; all he knows is that he is short of breath and weak. The doctors do the normal stuff. He is treated with drugs to slow the rate and undergoes cardioversion. During the hospital stay, he receives a stress test and an implantable loop recorder. He goes home on a couple of medications. The expensive implanted monitor shows rare episodes of short-lived AF, less than 1% of the time. The patient feels great. But here’s the kicker: his doctor recommends an AF ablation. This is nuts. The man has had one episode of AF. He has...
Source: Dr John M - July 13, 2016 Category: Cardiology Authors: Dr John Source Type: blogs

Arnold Schwarzenegger shouldn’t receive better care than our veterans
When Arnold Schwarzenegger was governor, he decided that you and I don’t need to have physicians in charge of our anesthesia care, and he signed a letter exempting California from that federal requirement. Luckily most California hospitals didn’t agree, and they ignored his decision. When he needed open-heart surgery to replace a failing heart valve, though, Governor Schwarzenegger saw things differently. He chose Steven Haddy, MD, the chief of cardiovascular anesthesiology at Keck Medicine of USC, to administer his anesthesia. Now some people in the federal government have decided that veterans in VA hospitals...
Source: Kevin, M.D. - Medical Weblog - July 13, 2016 Category: Journals (General) Authors: Tags: Physician Surgery Source Type: blogs

Two recent stories of EHR un-exceptionalism, and a connection to prior HC Renewal posts including my own experiences
Conclusions During the initial phase of implementation of an EHR, inaccuracies were more common in progress notes in the EHR compared to the paper charts. Residents had a lower rate of inaccuracies and omissions compared to attending physicians. Further research is needed to identify training methods and incentives that can reduce inaccuracies in EHRs during initial implementation.Apparently not covered in the article was the issue of patient harms that might have occurred (and could still occur) due to the "significantly higher rate of inaccurate documentation" in the EHR.   "Beaumont Hospital&quo...
Source: Health Care Renewal - July 13, 2016 Category: Health Management Tags: Beaumont Hospital cerner healthcare IT difficulties healthcare IT litigation Mismanagement PinnacleHealth Siemens Siemens Healthcare Soarian Source Type: blogs

CMS Receives Hundreds of Comments to include CME in MACRA
With the nearly 4,000 comments now in for the proposed MACRA rule, we are taking a look at what organizations had to say about including Continuing Medical Education (CME) as a Clinical Practice Improvement Activity (CPIA) under the new Merit-based Incentive Payment System (MIPS). Across the board, medical organizations and physicians were extremely supportive of including CME as a CPIA and strongly encouraged CMS to include CME-related language in the final rule. For example, an article by MeetingsNet highlights the hundreds of comments submitted describing the value of CME. As suggested by the CME Coalition's comments, C...
Source: Policy and Medicine - July 12, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Exablate Neuro MRI-Guided Focused Ultrasound for Essential Tremor Now Available in U.S.
INSIGHTEC, a company out of Israel, has announced receiving FDA approval to offer its Exablate Neuro MRI-guided focused ultrasound system as a treatment option for essential tremor in patients not responding to meds. The technology delivers sound waves powerful and focused enough to non-invasively ablate bits of brain tissue responsible for generating improper neural signals. Treatment is fairly short, and results are often confirmed within seconds, before the patient is even pulled out of the machine. Anesthesia is not necessary during the procedure, and the patient gets to go home right after. Some de...
Source: Medgadget - July 12, 2016 Category: Medical Equipment Authors: Editors Tags: Neurology Radiology Source Type: blogs

Why obstetric anesthesiology is the next frontier in medicine
There’s a lot of fear and anxiety about the job market with recent medical school graduates. The 2008 crisis almost collapsed the housing market and many of our large banks, prized institutions, and beacons of financial stability, dissolved overnight.  If you combine these events with the financial burden of student loans that many graduates have, it’s easy to see why many medical students are somewhat skeptical of the job market. In anesthesiology, the influx of mid-level providers has forced many residents to add an extra year of training. In most cases, job stability plays a big role in the decision to ...
Source: Kevin, M.D. - Medical Weblog - July 12, 2016 Category: Journals (General) Authors: Tags: Physician OB/GYN Source Type: blogs

Physicians go flatline on EHR enthusiasm
In a new study, physicians' enthusiasm levels for EHR's seem to resemble this EKG:Do physicians really experience a satisfaction 'J-curve' with EHRs? Max Green July 6, 2016 http://www.beckershospitalreview.com/healthcare-information-technology/do-physicians-really-experience-a-satisfaction-j-curve-with-ehrs.html There's a school of thought about EHR adoption that suggests physicians experience an initial decrease in their positive perceptions of the technology, but over time those levels creep back up and ultimately surpass their pre-implementation perceptions. But does that J-curve actually exists for EHR...
Source: Health Care Renewal - July 8, 2016 Category: Health Management Tags: Becker ' s Hospital Review EPIC healthcare IT dissatisfaction JAMIA Max Green Source Type: blogs

The perioperative surgical home: What’s in a name?
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Our institution, like countless others across the country, has been working to institute processes to achieve the “triple aim” of improving the quality of health care, increasing patient satisfaction, and reducing the cost of providing that care. As chair of my anesthesiology department, a number of our faculty were intrigued by the perioperative surgical home (PSH) concept — a surgical process in which patient-centered, physician-led, team-based coordinated care spans the entire surgical experience, from the ...
Source: Kevin, M.D. - Medical Weblog - July 7, 2016 Category: Journals (General) Authors: Tags: Physician Surgery Source Type: blogs

Physician-led anesthesia is safe anesthesia
Many people, even those who work in the operating room every day, take safe anesthesia care for granted.  There has been growing pressure recently to abandon the team model and remove physician anesthesiologists’ supervision of nurse anesthetists with the latest threat coming from within Veterans Affairs (VA) health care.  For our veterans, our heroes and arguably some of the most medically complex patients, having both physician anesthesiologists and nurse anesthetists working together as a team makes sense. Having a team with members who train differently and have different perspectives can only benefit t...
Source: Kevin, M.D. - Medical Weblog - July 5, 2016 Category: Journals (General) Authors: Tags: Physician Surgery Source Type: blogs

LITFL Review 238
Welcome to the 238th 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 chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Radiopaedia has the entire SMACC Radiology playlist available to view. All cases, discussion notes—everything! Awesome #FOAMed. [SO]   The Best of #FOAMed Emergency Medicine Sydney HEMS have just released a wealth of superb Pre Hospi...
Source: Life in the Fast Lane - July 3, 2016 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Why we are grateful to Dr Malpani
Dr. Malpani's changed our lives forever. They gave us our naughty miracle. It was in our first meeting or very soon after that, Dr Malpani asked us to read out the Serenity Prayer. I can write volumes and speak to no end about our experience and the support received during our journey to a miracle. We were a complex case; at least I like to believe so. It is here that the Serenity Prayer brought some sanity to our lives. We had some misses and some false starts until we had success. Our success was only due to the efforts of my wife and the conviction she had in her Dr. Our success was only due to the Dr we had and the sup...
Source: Dr.Malpani's Blog - July 2, 2016 Category: Reproduction Medicine Tags: drmalpani dr malpani ivf IVF success story Malpani Clinic malpani review Source Type: blogs

When TSA is Terrible Staff Agency
This is absolutely inexcusable! A young woman, Hannah Cohen, has had a tumor removed from her brain, which combined with radiation treatments has made her blind and deaf on her left side, along with limited speech and mobility. She and her mother were flying home to Chattanooga a day post-anaesthesia from another treatment at St […] (Source: Andrea's Buzzing About:)
Source: Andrea's Buzzing About: - July 1, 2016 Category: Disability Authors: andrea Tags: Abuse Accessibility Deaf / Hard of Hearing Physical impairments Travel Source Type: blogs

When Common Sense And Public Health Prevail: Whole Woman’s Health v. Hellerstedt
On June 27, 2016 the United States Supreme Court handed down its ruling in Whole Women’s Health et al. v. Hellerstedt, one of its culminating decisions for the 2015-2016 term. By a 5-3 majority, the Court ruled unconstitutional two specific provisions of a Texas statute (House Bill 2), which was enacted in 2013 following a dramatic debate that featured a national headline-making filibuster by State Senator Wendy Davis. The two provisions at issue were first, a requirement that physicians performing surgical or medical abortions have active admitting privileges at a hospital within 30 miles, and second, that clinics p...
Source: Health Affairs Blog - July 1, 2016 Category: Health Management Authors: Sara Rosenbaum Tags: Equity and Disparities Featured Insurance and Coverage Medicaid and CHIP Public Health Quality Abortion Planned Parenthood v. Casey Supreme Court Texas Whole Woman’s Health v. Hellerstedt Women's Health Source Type: blogs

The widespread use of fentanyl escalates the risk of overdose
A fentanyl overdose led to the recent death of musician and singer Prince, according to the medical examiner’s report released June 2. The drug seems likely to become as notorious as propofol did after the death of Michael Jackson in 2009. For all of us in anesthesiology who’ve been using fentanyl as a perfectly respectable anesthetic medication and pain reliever for as long as we can remember, it’s startling to see it become the cause of rising numbers of deaths from overdose.  Fentanyl is a potent medication, useful in the operating room to cover the intense but short-lived stimulation of...
Source: Kevin, M.D. - Medical Weblog - June 30, 2016 Category: Journals (General) Authors: Tags: Physician Medications Pain management Source Type: blogs

Research and Reviews in the Fastlane 140
In this study of 187 traumatic arrest patients, the survival rate was 3.2%. The authors found that if the patient had no cardiac motion AND no pericardial effusion, the mortality was 100%. This potentially identifies a group in which providers should not be subjected to the risks of thoracotomy. Recommended by Anand Swaminathan The Best of the Rest Emergency medicine Cheng YJ et al. The Role of Macrolide Antibiotics in Increasing Cardiovascular Risk. J Am Coll Cardiol. 2015. PMID 26564594 The harm is small – 1 in ~25,000 prescriptions – but this is another call to avoid unnecessary use of macrolide antib...
Source: Life in the Fast Lane - June 30, 2016 Category: Emergency Medicine Authors: Soren Rudolph Tags: Clinical Research Education Emergency Medicine Intensive Care LITFL Pre-hospital / Retrieval R&R in the FASTLANE Resuscitation Review Trauma critical care Source Type: blogs

Davos Technique Gains Traction for Shoulder Dislocations
Multiple methods are touted for reducing anterior shoulder dislocations, and every emergency physician seems to have gravitated to one or two methods that he uses routinely. Why someone prefers one technique over another is not clear, but the factors for technique selection seem to be training, ease of application, and prior successful experiences.Every reduction procedure will have some degree of applied rotation, torque, and traction, and pain is a common and unavoidable theme. Unfortunately, not all shoulder reductions are created equally. Variations in human anatomy, time duration of dislocation, and the actual locatio...
Source: M2E Too! Mellick's Multimedia EduBlog - June 27, 2016 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

10% Happier: Mindfulness Meditation Courses with Dan Harris and Joseph Goldstein
When I expressed an interest in Mindfulness meditation last Christmas, a family member suggested I read “10% Happier” by Dan Harris.  I did, and the book (which is subtitled ‘Meditation for Fidgety Skeptics’) made a real impression on this fidgety, skeptical, anesthesiologist. After the book, I found the 10% Happier iPhone app to be incredibly helpful in continuing to try to establish my practice.  What sets this app apart from others, in my view, is the short video interview segments Dan does with Joseph Goldstein and others to educate the user about meditation, the challenges that may ar...
Source: Waking Up Costs - June 26, 2016 Category: Anesthesiology Authors: Clark Tags: Meditation Source Type: blogs

Demystifying General Anesthetics
When Margaret Sedensky, now of Seattle Children’s Research Institute, started as an anesthesiology resident, she wasn’t entirely clear on how anesthetics worked. “I didn’t know, but I figured someone did,” she says. “I asked the senior resident. I asked the attending. I asked the chair. Nobody knew.” For many years, doctors called general anesthetics a “modern mystery.” Even though they safely administered anesthetics to millions of Americans every year, they didn’t know exactly how the drugs produced the different states of general anesthesia. These states includ...
Source: Biomedical Beat Blog - National Institute of General Medical Sciences - June 22, 2016 Category: Research Authors: Carolyn Beans Tags: Pharmacology Anesthesiology Big Questions Source Type: blogs

A Tale of Two Interviews: An Interviewer’s Account of Combining Long- and Short-Form Interviews
Editor’s Note: This post is one of two pieces on the hybrid interview format used at the University of Michigan Medical School. Check back next week for the second piece. By: Heather Hervey-Jumper, MD Heather Hervey-Jumper is a clinical instructor at the Department of Anesthesiology, University of Michigan Health System, Ann Arbor, Michigan. An applicant having a strong knowledge base is essential in choosing medical school trainees but so many other skills are involved in building a physician. Compassion, professionalism, and communication, just to name a few, are essential skills for building our future doctor...
Source: Academic Medicine Blog - June 21, 2016 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective hybrid interview format medical school admissions medical school interview multiple mini interview University of Michigan Medical School Source Type: blogs

A Tale of Two Interviews: An Interviewer ’s Account of Combining Long- and Short-Form Interviews
Editor’s Note: This post is one of two pieces on the hybrid interview format used at the University of Michigan Medical School. Read the other piece here. By: Heather Hervey-Jumper, MD Heather Hervey-Jumper is a clinical instructor at the Department of Anesthesiology, University of Michigan Health System, Ann Arbor, Michigan. An applicant having a strong knowledge base is essential in choosing medical school trainees but so many other skills are involved in building a physician. Compassion, professionalism, and communication, just to name a few, are essential skills for building our future doctors. Tra...
Source: Academic Medicine Blog - June 21, 2016 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Guest Perspective hybrid interview format medical school admissions medical school interview multiple mini interview University of Michigan Medical School Source Type: blogs

Cross-Cultural Perspectives on Brain Death
Several weeks ago, Harvard Bioethics produced a recorded seminar on "Cross-Cultural Perspectives on Brain Death."  The panelists were Qing Yang, MD, PhD (Department of Anesthesia, Massachusetts General Hospital) and Robert D. Truog, MD (Director, Center for Bioethics and Professor of Medical Ethics, Anaesthesiology & Pediatrics at Harvard Medical School; Senior Associate in Critical Care Medicine at Children’s Hospital Boston). Even in the US, some controversy persists over the conceptual defensibility of brain death. Around the world, the philosophical defensibility of brain death is even more deb...
Source: blog.bioethics.net - June 21, 2016 Category: Medical Ethics Authors: Thaddeus Mason Pope, JD, PhD Tags: Health Care medical futility blog syndicated Source Type: blogs

The Politics of Fetal Pain: Why This Is Not A Legislative Issue
I read with interest the recent blog by my colleagues Paul Burcher and Claire Horner entitled “The Politics of Fetal Pain”. In their blog they discuss the recent fetal pain bill passed in Utah, which “requires the use of general anesthesia on women seeking abortions at 20 weeks gestation or later.” At stake is the concern that fetuses may be capable of experiencing pain by 20 weeks, which has prompted 12 states to restrict or prohibit abortions from that point on, instead of 24 weeks, which is the current standard. Burcher and Horner remind us that the issue of fetal pain has been a source of con...
Source: blog.bioethics.net - June 20, 2016 Category: Medical Ethics Authors: Bioethics Today Tags: Health Care Reproductive Medicine abortion syndicated Women's Reproductive Rights Source Type: blogs

Does Arnold Schwarzenegger Deserve Better Care Than Our Veterans Do?
By KAREN SIBERT, MD When Arnold Schwarzenegger was governor, he decided that you and I don’t need to have physicians in charge of our anesthesia care, and he signed a letter exempting California from that federal requirement. Luckily most California hospitals didn’t agree, and they ignored his decision. When he needed open-heart surgery to replace a failing heart valve, though, Governor Schwarzenegger saw things differently. He chose Steven Haddy, MD, the chief of cardiovascular anesthesiology at Keck Medicine of USC, to administer his anesthesia. Now some people in the federal government have decided that ve...
Source: The Health Care Blog - June 20, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

I’m in the wrong era of medicine to be a doctor. Here’s why.
As a doctor ready to finish my residency in anesthesiology, most people would assume I am thrilled to be at the finish line of this long, challenging and grueling process. While I am happy to move on and begin practicing on my own, I am also somewhat terrified of what lies ahead. It’s not caring for patients that I am afraid of, but the cultural state of medicine in the 21st century that I am worried about. Medicine has never been any safer than what it is now. Vaccinations have eradicated common diseases that killed millions. Dangerous medical procedures are now safe, and kids born with congenital defects have more ...
Source: Kevin, M.D. - Medical Weblog - June 18, 2016 Category: Journals (General) Authors: Tags: Physician Surgery Source Type: blogs

My attending is throwing scalpels. What do I do?
Dear Dr. Wible, Thank you for the work that you do. I have been following your push for humane medical education for several months now. I finally decided to contact you after reading your article about how “burnout” is actually abuse. I am a med student entering my third year. I have been consistently hearing horror stories from other students about the treatment we will receive on our clinical rotations — doctors belittling us, calling us names, screaming and yelling everyday, throwing scalpels in the operating room, not giving bathroom or lunch/dinner breaks, manhandling patients under anesthesia,...
Source: Kevin, M.D. - Medical Weblog - June 16, 2016 Category: Journals (General) Authors: Tags: Physician Medical school Source Type: blogs



2-Month Old Infant Suffered Apnea and Died Following 8 Vaccines
Conclusion After watching their son get buried, Cash’s parents were thrown into a world they didn’t know much about. They were now another set of grieving parents who senselessly lost their child due to medical practices recommended under a doctor’s care. Vaccines are being ignored when compiling infant mortality data. In 2013, Cash Dewayne Thomas was one of 23,440 babies who died in the United States before reaching their first birthday, according to the latest infant mortality data published in 2016. [19] About 11,300 newborns die within their first day of life, many soon after receiving their first hep...
Source: vactruth.com - June 16, 2016 Category: Allergy & Immunology Authors: Augustina Ursino Tags: Augustina Ursino Human Top Stories apnea Cash Dewayne Thomas Jesse Dewayne Thomas newborn vaccines truth about vaccines Vaccine Death Whitney Hill Source Type: blogs

A Patient-Centered Solution To Simultaneous Surgery
The practice of concurrent, or simultaneous, surgery has largely been hidden from public knowledge until recently, and current guidelines regulating the practice fall short in protecting and serving patients in crucial ways. Simultaneous surgery occurs when one surgeon, with the help of assistants, performs two surgeries on two different patients in different operating rooms at the same time. A series of articles published last year in The Boston Globe propelled the practice into public consciousness. In response to the ensuing outcry the American College of Surgeons revised their guidelines with respect to simultaneous su...
Source: Health Affairs Blog - June 14, 2016 Category: Health Management Authors: James Rickert Tags: Featured Health Professionals Quality patient-centered care simultaneous surgery surgeons Source Type: blogs

Prescription Drug Shortages: Data Limitations In An Era Of Big Data
In 2012 hundreds of prescription drugs were in short supply in the United States. Over 80 percent of these drugs were generic and many were commonly used as anti-infective, anesthesia, and chemotherapy agents (ASPE 2011; Woodcock and Wosinska 2012). That same year, the Food and Drug Administration (FDA) was given new and expanded powers to monitor and resolve shortages under the Food and Drug Administration Safety and Innovation Act (FDASIA). A nice recent piece in Health Affairs evaluates trends in drug shortages before and after the passage of FDASIA and by an acute versus non-acute care drug categorization. Using 2001-2...
Source: Health Affairs Blog - June 14, 2016 Category: Health Management Authors: Mireille Jacobson and Hanna Liu Tags: Drugs and Medical Technology Featured Drug Enforcement Administration drug shortages Source Type: blogs

Medical workforce census report 2015
This report provides comprehensive data on the anaesthetics workforce in the UK. It finds that while there have been increases in the numbers of consultant and specialty and associate specialist doctors since the previous census in 2010, the 2015 report confirms a number of challenges facing the specialty, including an existing unmet need for anaesthetics and intensive care medicine in trusts across the UK. Report Press release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - June 12, 2016 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Workforce and employment Source Type: blogs

When this doctor retires early, here are 4 things he’ll miss
As a physician who is planning an early retirement, and is writing about the topic often, I find that retirement is frequently on my mind. It’s not difficult to articulate my desire for an early retirement. I crave the freedom and time with my family. I look forward to restful nights free from the threat of the loathsome pager. Another round of MOC is not for me, and I’m ready to live life at a different pace, exploring hobbies, staying fit, and challenging my mind in novel ways. However, I would be lying if I were to say I feel no trepidation when I contemplate my exit strategy. You see, despite the typical st...
Source: Kevin, M.D. - Medical Weblog - June 10, 2016 Category: Journals (General) Authors: Tags: Physician Surgery Source Type: blogs

Joint Replacement in Ambulatory Care Clincs; A Major Financial Threat to Hospitals
There is a major financial threat sneaking up on hospitals about which some executives may may not be fully aware. It's the recruitment of arthroplasty patients by free-standing ambulatory orthopedic surgery clinics. This topic was covered in great detail in a recent article referring to such clinic surgical procedures as "better and cheaper" (see: Replacing joints faster, cheaper and better?). Below is an excerpt from it but be sure to read the whole thing if interested because it's worth your time: ...[A patient's recent hip replacement] experience with.....
Source: Lab Soft News - June 10, 2016 Category: Laboratory Medicine Authors: Bruce Friedman Source Type: blogs

The Opioid Crisis: Nociception, Pain and Suffering
By MARTIN SAMUELS, MD In order to understand the concept of pain and its relationship to the current opioid crisis, it is prudent to review the neurology of pain an why it exists.  Several concepts are important to integrate. Nociception:  Nociception is the capacity to sense a potentially tissue damaging (noxious) stimulus.  To illustrate this one should place a forefinger in a glass of ice water and determine how long passes until an unpleasant sensation arises.  If one performs this experiment in a large group, one can recognize that, although the stimulus is the same (a glass of ice water), the...
Source: The Health Care Blog - June 10, 2016 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs