I ’m your anesthesiologist. Let me explain what that means.
It’s still dark out when I walk into the busy and bustling preoperative area where patients and their family members crowd into small bays. They hand over their personal belongings to the RNs and their trust to me. As I walk in, I grab my patient’s hand, smile and say, “Hello. My name is Dr. Shillcutt. I am a cardiac anesthesiologist, and I am going to take care of you today.” I am an anesthesiologist, which means I take care of patients who are sick or injured and need surgery. I “put you to sleep,” but more importantly, I wake you up. When I first told my mother I was going to pursue a...
Source: Kevin, M.D. - Medical Weblog - June 30, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/sasha-k-shillcutt" rel="tag" > Sasha K. Shillcutt, MD < /a > Tags: Physician Surgery Source Type: blogs

Channel Medsystems ’ Cerene Cryotherapy Device for Menstrual Bleeding Cleared in Europe
Channel Medsystems, a company based in San Francisco, California, won the European CE Mark to introduce its Cerene cryotherapy device in the European market. The endometrial ablation device is designed to help address heavy menstrual bleeding in premenopausal women who are done having children. Unlike other existing endometrial ablation devices, when using the Cerene the patient may not need any sedation or anesthesia, as there may not be much discomfort during a procedure that takes less than three minutes. Once the tip of the device reaches the fundus, nitrous oxide is released into an inflatable pouch that expands ...
Source: Medgadget - June 29, 2017 Category: Medical Devices Authors: Editors Tags: Ob/Gyn Source Type: blogs

Transforming Tragedy Into Effective Maternal Mortality Prevention Efforts
Making her way to her baby’s crib at the end of naptime, a 29-year-old, first-time mother falls to the ground unconscious. She never recovers. Until that day, despite the exhaustion that inevitably accompanies life with a newborn, the young woman appeared to be recovering well from childbirth. Even though she’d battled hypertension throughout her pregnancy, after delivery, her blood pressure readings were normal and she was discharged. Her family is bewildered and distraught. It will be several confusing and agonizing weeks before they learn what took the life of this young, vibrant mother. While this may sound...
Source: Health Affairs Blog - June 29, 2017 Category: Health Management Authors: Wanda Barfield Tags: Featured Public Health Quality CDC maternity care postpartum care Source Type: blogs

When impossible pain is, in fact, possible
I had my first outpatient surgical procedure when I was still in high school and needed a plantar wart removed from the sole of my foot. As the doctor injected the area with a local anesthetic, he explained he did these procedures all the time, and I wouldn’t feel a thing. After a short wait, he began to dig out the deeply embedded wart with a hooked scalpel. With the first cut of the scalpel, excruciating pain exploded in my foot, and I was shocked speechless. I froze, paralyzed, terrified that any movement would jostle that knife digging into my flesh. Meanwhile, the doctor and nurse were cheerful and relaxed as th...
Source: Kevin, M.D. - Medical Weblog - June 28, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/angelika-byczkowski" rel="tag" > Angelika Byczkowski < /a > Tags: Patient Rheumatology Source Type: blogs

Light-Sheet Microscopy Images Tumor Margins Intraoperatively to Guarantee Full Tumor Removal
Surgical tumor removal, particularly within the breasts, suffers from imprecision related to identifying the margins of where the tumor is. That’s because tumors are often indistinguishable from healthy tissue until they’re visualized and analyzed by pathologists using laboratory microscopes. The time it takes to confirm that sampled tissue is clear of cancerous cells takes longer than a person can stay open and under anesthesia, so the final word usually comes in only after the patient has been stitched up and so too often leads to revision surgeries. Researchers at the University of Washington have now d...
Source: Medgadget - June 27, 2017 Category: Medical Devices Authors: Editors Tags: Pathology Surgery Source Type: blogs

Alzheimer's and Anesthesia
Alzheimer's and anesthesia don't mix well. Some physicians are advising their patients that are already diagnosed with Alzheimer ’s to avoid surgery unless absolutely necessary.By Sydney S. Farrier, LCSWHow often have you heard the comment about an older person who recently underwent a major surgery, "She was fine until she had that (hip surgery, knee replacement, cardiac surgery, etc) but now she seems confused."Learn More -What is the Difference Between Alzheimer ’s and DementiaThis week I was visiting with an attractive woman in her 80's who had a knee surgery under a general anesthesia a couple of...
Source: Alzheimer's Reading Room, The - June 26, 2017 Category: Neurology Tags: alzheimer's alzheimer's anesthesia Alzheimers Dementia anesthesia dementia care of dementia patients dementia care dementia made worse by anesthesia dementia news health Source Type: blogs

6 Questions You Need to Ask About Surgery, Anesthesia and Dementia
This article -3 Things Everyone Should Know About Anesthesia - should be helpful in helping you ask the right questions and how to formulate those question. You might want to print the article and have it in hand if surgery is on the horizon.Does Anesthesia Cause Dementia or Memory Loss in the Elderly?Related ContentTest Your Memory for Alzheimer's (5 Best Tests)Alzheimers Dementia SymptomsCare of Dementia PatientsUrinary Tract Infections Can Hasten Memory Loss in Alzheimer's PatientsProblems with Balance, Walking, Falling an Early Sign of DementiaAlzheimer's Care Nursing HomesThe 7 Stages of Alzheimer'sBob DeMarco is the ...
Source: Alzheimer's Reading Room, The - June 26, 2017 Category: Neurology Tags: alzheimer's and anesthesia Alzheimers Dementia anesthesia dementia family health memory surgery anesthesia Source Type: blogs

Exercise? Who me? Yoga or physiotherapy or education …
This study is a “non-inferiority” study, looking to establish whether yoga or physiotherapy, or indeed education, can help people living with chronic low back pain. Now I’m not going to do a blow-by-blow analysis of the study, that’s for you to do. What I am going to do is look at what the yoga consisted of – and see why, perhaps, yoga is getting so much research interest. BTW, yoga was found to be non-inferior to physiotherapy, and both yoga and PT were more likely than education to have a clinically meaningful response, although neither yoga nor PT were superior to education. This is the bas...
Source: HealthSkills Weblog - June 25, 2017 Category: Anesthesiology Authors: adiemusfree Tags: Back pain Chronic pain Coping strategies Motivation Pain conditions Professional topics Research Science in practice biopsychosocial function Health Therapeutic approaches Source Type: blogs

Depression Can Be Treated With Magnets, Research Finds
The procedure doesn't require anaesthesia or sedation, taking around 40 minutes per session. • Try one of PsyBlog's ebooks, all written by Dr Jeremy Dean: Activate: How To Find Joy Again By Changing What You Do (NEW) The Anxiety Plan: 42 Strategies For Worry, Phobias, OCD and Panic Spark: 17 Steps That Will Boost Your Motivation For Anything (Source: PsyBlog | Psychology Blog)
Source: PsyBlog | Psychology Blog - June 25, 2017 Category: Psychiatry & Psychology Authors: Jeremy Dean Tags: Depression Source Type: blogs

Radiologists Receive the Most Inbound Referrals of Any Specialist
Referrals are a main facet of medicine ’s ecosystem. Amino, a platform that synthesizes data from insurance companies to create a transparent healthcare marketplace, wanted to get a full perspective of how referrals work. So they evaluated211 millioninter-specialty referrals from 2016 to determine the top 50 most common referrals. They found that radiologists received more inbound referrals than any other specialist.Amino ’s data team discovered that internists, family practitioners, emergency medicine, pediatricians, and OB/GYNs made the most outbound referrals, and family practitioners and ER physicians had t...
Source: radRounds - June 24, 2017 Category: Radiology Authors: Julie Morse Source Type: blogs

The Payment Reform Landscape: Is The Debate Over Retrospective Versus Prospective Bundled Payments A Distraction?
Based on surveys of health plans by Catalyst for Payment Reform, less than 3 percent of payments in the commercial market are “bundled.” One can argue that there have been more conferences and webinars about bundled payment than actual bundled payments. In the public sector, however, there is much more experimentation with and usage of bundled payment through Medicare and Medicaid. There is good reason to pursue bundled payment. At least in theory, a bundle represents the best thinking on how much it costs to treat the course of an identifiable illness, disease, or injury. It also addresses the tendency to infl...
Source: Health Affairs Blog - June 23, 2017 Category: Health Management Authors: François de Brantes and Suzanne Delbanco Tags: Costs and Spending Payment Policy bundled payment Catalyst for Payment Reform Source Type: blogs

The opioid crisis changed how doctors think about pain - Vox
WILLIAMSON, West Virginia — This town on the eastern border of Kentucky has 3,150 residents, one hotel, one gas station, one fire station — and about 50 opiate overdoses each month.On the first weekend of each month, when public benefits like disability get paid out, the local fire chief estimates the city sees about half a million dollars in drug sales. The area is poor — 29 percent of county residents live in poverty, and, amid the retreat of the coal industry, the unemployment rate was 12.2 percent when I visited last August— and those selling pills are not always who you'd expect."Elder...
Source: Psychology of Pain - June 22, 2017 Category: Anesthesiology Source Type: blogs

How Do You Deal With Death All the Time?
By Shannon Tapia My husband the Anesthesiologist came home one evening solemn, affected, not himself.  His patient died in the recovery room.  It was sudden, unexpected for my husband, and despite the team’s swift efforts and perfectly executed code, the patient died anyway.  It’s relevant to note that his patient was an almost 90 year […] (Source: blog.bioethics.net)
Source: blog.bioethics.net - June 20, 2017 Category: Medical Ethics Authors: reflectivemeded Tags: Health Care humanism medical professionalism Professional Development Self-Care Wellness syndicated Source Type: blogs

Pacing, pacing, pacing – good, bad, or … ?
There’s nothing that pain peeps seem to like more than a good dispute over whether something is good, or not so good for treatment. Pacing is a perennial topic for this kind of vexed discussion. Advocates say “But look at what it does for me! I can do more without getting my pain out of control!” Those not quite as convinced say “But look at how little you’re doing, and you keep letting pain get in the way of what you really want to do!” Defining and measuring pacing is just as vexed as deciding whether it’s a good thing or not. Pacing isn’t well-defined and there are several...
Source: HealthSkills Weblog - June 18, 2017 Category: Anesthesiology Authors: adiemusfree Tags: 'Pacing' or Quota Assessment Chronic pain Clinical reasoning Coping Skills Pain conditions Research Science in practice biopsychosocial pain management self management Therapeutic approaches Source Type: blogs

Even if you can ’t see sexism immediately, it’s still there
For the most part, the sexism in medicine is not subliminal at all — it’s quite overt. Unless you’re a female physician, you probably are unaware that it’s still an ever-present reality for us. I want to note that there are very good men out there who are trying their best to be advocates for equality in our field even though they cannot fully appreciate the female physician plight. My father is one. My husband, an anesthesiologist, is one. The male physician-entrepreneur I met with last week to discuss a partnership in my new solo practice with his clinic system is one. These men are the “He&...
Source: Kevin, M.D. - Medical Weblog - June 15, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/shannon-tapia" rel="tag" > Shannon Tapia, MD < /a > Tags: Physician Primary care Source Type: blogs

Physicians are not fundamentally different from their patients
Delivered at the Harvard Medical School Class Day Ceremony, May 25, 2017. Distinguished faculty, dedicated staff, and most importantly, loving parents and family members: Thank you for all you’ve done to support us and transform us into doctors. Harvard Medical School Class of 2017, congratulations. It is an enormous honor to address you all today. When I was a third-year medical student, I scrubbed in on the surgery of a woman with ovarian cancer. The purpose of the surgery was to see whether her cancer had spread to other organs. The surgeon instructed me to put my hand on the patient’s liver. As I ran my glo...
Source: Kevin, M.D. - Medical Weblog - June 14, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/colleen-farrell" rel="tag" > Colleen Farrell, MD < /a > Tags: Education Medical school Source Type: blogs

Neurobiology of Pain - Journal - Elsevier
Neurobiology of Pain is an international journal for the publication of basic and translational research on the mechanisms of acute and chronic pain. It focuses on experimental studies of pain mechanisms at every level from molecular and cellular to brain imaging and behavioural. The journal primarily publishes original basic and translational studies, but will consider clinical studies which address mechanistic aspects of pain based on experimental approaches in human subjects.The scope of the journal addresses all areas of pain neurobiology, including:Molecular substrates and cell signalingGenetics and epigeneticsSp...
Source: Psychology of Pain - June 13, 2017 Category: Anesthesiology Source Type: blogs

Regulatory Learnings from the Real World
In March, the FDA’s Anesthetic and Analgesic Drug Products Advisory Committee (AADPAC) and the Drug Safety and Risk Management Advisory Committee (DSARM). voted 18-8 that Opana ER’s benefits do not outweigh its risks. And on June 8th, the other shoe dropped. (Source: drugwonks.com Blog)
Source: drugwonks.com Blog - June 12, 2017 Category: Pharmaceuticals Source Type: blogs

Returning to work, good or bad?- a very complex question
One of the main reasons returning to work is a priority in many healthcare systems is simply that compensation and off-work benefits is the most costly portion of the bill for people with ill health. This naturally leads to a strong emphasis in most rehabilitation, especially musculoskeletal rehabilitation in New Zealand, to help people return to work as soon as practicable. At times the process can be brutal. In my own case, after 18 months of working part-time due to post-concussion symptoms after a “mild” traumatic brain injury, I had the hard word put on me to get back to my job or I’d be sent to work...
Source: HealthSkills Weblog - June 11, 2017 Category: Anesthesiology Authors: adiemusfree Tags: Chronic pain Clinical reasoning Research Return to Work biopsychosocial function Health healthcare pain management RTW Therapeutic approaches Source Type: blogs

Fight Aging! Newsletter, June 12th 2017
In this study, we focused on two pathways of cardiomyocytes or heart cells: the Hippo pathway, which is involved in stopping renewal of adult cardiomyocytes, and the dystrophin glycoprotein complex (DGC) pathway, essential for cardiomyocyte normal functions." Previous work had hinted that components of the DGC pathway may somehow interact with members of the Hippo pathway. The researchers genetically engineered mice to lack genes involved in one or both pathways, and then determined the ability of the heart to repair an injury. These studies showed for the first time that dystroglycan 1, a component of the DGC ...
Source: Fight Aging! - June 11, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

EasyOne Air Portable, Calibration-Free Spirometer from ndd Medical
ndd Medical Technologies, a company with offices in Andover, MA and Zurich, Switzerland, is releasing a new professional spirometer for primary care physicians. The EasyOne Air uses the company’s TrueFlow ultrasound technology that does not require any calibration or maintenance, allowing it to be used for years. It has a rechargeable battery that’s replenished when connected to a base station, and when disconnected it can be carried in one hand. A color touchscreen is used to select settings and to review the readings, which are also interpreted to the ATS/ERS guidelines. The spirometer can connect to in-...
Source: Medgadget - June 8, 2017 Category: Medical Devices Authors: Editors Tags: Anesthesiology Cardiology Medicine Surgery Thoracic Surgery Source Type: blogs

NIH Releases Federal Pain Research Strategy Draft Research Priorities - American Society of Anesthesiologists
On May 25, the Interagency Pain Research Coordinating Committee (IPRCC) and the Office of Pain Policy of the National Institutes of Health (NIH) released draft Federal Pain Research Priorities, which were presented and discussed at a forum and public comment period on June 1. The forum immediately followed the Annual NIH Pain Consortium Symposium, where presentations highlighted multidisciplinary strategies for the management of pain. Following the open public comment period, written comments will be accepted until June 6.The Federal Pain Research Strategy (FPRS) is an effort to oversee development...
Source: Psychology of Pain - June 7, 2017 Category: Anesthesiology Source Type: blogs

Research and Reviews in the Fastlane 185
This article on remifentanyl tolerance and hyperalgesia is nerdy, focussed on perioperative anaesthesia, but good. Recommended by: Matthew MacPartlin Emergency Medicine Verma AA et al, for the GEMINI Investigators. Pulmonary Embolism and Deep Venous Thrombosis in Patients Hospitalized With Syncope: A Multicenter Cross-sectional Study in Toronto, Ontario, Canada. JAMA Intern Med. PMID: 28492876 A quick update on PESIT. This retrospective chart review tried to replicate the PESIT inclusion criteria. They identified 1305 patients admitted with first time syncope. Ultimately, 11 were diagnosed with PE and 10 with DVT...
Source: Life in the Fast Lane - June 7, 2017 Category: Emergency Medicine Authors: Justin Morgenstern Tags: Anaesthetics Emergency Medicine Intensive Care R&R in the FASTLANE critical care EBM Education literature recommendations research and reviews Source Type: blogs

Research and Reviews in the Fastlane 185
This article on remifentanyl tolerance and hyperalgesia is nerdy, focussed on perioperative anaesthesia, but good. Recommended by: Matthew MacPartlin Emergency Medicine Verma AA et al, for the GEMINI Investigators. Pulmonary Embolism and Deep Venous Thrombosis in Patients Hospitalized With Syncope: A Multicenter Cross-sectional Study in Toronto, Ontario, Canada. JAMA Intern Med. PMID: 28492876 A quick update on PESIT. This retrospective chart review tried to replicate the PESIT inclusion criteria. They identified 1305 patients admitted with first time syncope. Ultimately, 11 were diagnosed with PE and 10 with DVT...
Source: Life in the Fast Lane - June 7, 2017 Category: Emergency Medicine Authors: Justin Morgenstern Tags: Anaesthetics Emergency Medicine Intensive Care R&R in the FASTLANE critical care EBM Education literature recommendations research and reviews Source Type: blogs

Third Pole ’s On-Demand Portable iNO: Interview with Dr. Warren Zapol
Inhaled nitric oxide (iNO) relaxes blood vessels in the lungs and is an important and life-saving treatment for pulmonary hypertension. Current iNO delivery solutions are estimated to cost $2,800 per day and rely on compressed gas delivery which limits accessibility and applicability of this technology worldwide. Dr. Warren Zapol and team, led by his son David Zapol, have launched the company Third Pole with technology licensed from Massachusetts General Hospital (MGH) with the goal of developing next generation life-­saving therapies capable of serving new cardio-pulmonary markets. Their initi...
Source: Medgadget - June 7, 2017 Category: Medical Devices Authors: William Kethman Tags: Anesthesiology Cardiac Surgery Cardiology Critical Care Exclusive Medicine Source Type: blogs

An Update on the Work of Oisin Biotechnologies: Building Therapies for Aging, Cancer, and Other Conditions by Targeting Harmful Cells for Destruction
Oisin Biotechnologies is a creation of our core community of longevity advocates, researchers, philanthropists, and others. The present CEO, Gary Hudson, was one of the first donors to support the newly formed Methuselah Foundation fifteen years ago. The company's seed funding was provided by the Methuselah Foundation and SENS Research Foundation a few years ago. A number of people in the audience here, myself included, invested in the company early last year in order to support this initiative. The initial goal of development at Oisin Biotechnologies is the targeted destruction of senescent cells, a path to produce one of...
Source: Fight Aging! - June 5, 2017 Category: Research Authors: Reason Tags: Healthy Life Extension Community Source Type: blogs

An Interview with Orthopaedic Oncologist Dr. Vincent Ng
Dr. Vincent Ng is an orthopaedic oncologist with the University of Maryland Greenebaum Comprehensive Cancer Center and an Assistant Professor or Orthopaedics with the University of Maryland School of Medicine.  Dr. Ng specializes in treating bone cancer and soft tissue sarcoma.  Below he answers common questions about orthopaedic oncology. What is an orthopaedic oncologist? How do they differ from surgical oncologists? “An orthopaedic oncologist specializes in bone and soft tissue tumors.  I treat any adult or pediatric patient with any bone or soft tissue tumor/lesion/mass, whether benign or malignan...
Source: Life in a Medical Center - June 2, 2017 Category: Universities & Medical Training Authors: UMMC Tags: Cancer Doctors bone cancer oncology orthopedics Source Type: blogs

On World MS Day, Multiple Sclerosis Had Me Facedown in My Soup
Yesterday was World MS Day, which this year had the theme #LifewithMS. I’d hoped to spend the day celebrating what I call “the living part” of our life with multiple sclerosis (MS). However, the week leading up to the big day had been rather busy. One day a large group of friends who were on a tour of Ireland came for a dinner party, and the next day renowned musicians Hanz Araki and Owen Marshall arrived and stayed with us for a few days. On top of that, there were behind-the-scenes preparations to be done for MS Ireland’s World MS Day event announcing the&nb...
Source: Life with MS - June 1, 2017 Category: Neurology Authors: Trevis Gleason Tags: multiple sclerosis awareness Living with MS MS fatigue trevis gleason world MS day Source Type: blogs

The opioid epidemic could be cured with virtual-reality worlds that let patients escape their pain — Quartz
"It's like a crawly feeling inside," says Judy*."You get hot, then chilled, and you feel like you want to run away." The 57-year-old has short dark-grey hair and a haunted expression. She's breathless and sits with her right leg balanced up on her walking stick, rocking it back and forth as she speaks.Judy explains that she suffers from constant, debilitating pain: arthritis, back problems, fibromyalgia and daily migraines. She was a manager at a major electronics company until 2008, but can no longer work. She often hurts too much even to make it out of bed.She's taking around 20 different ...
Source: Psychology of Pain - May 30, 2017 Category: Anesthesiology Source Type: blogs

Targeting the people who need it most
This study provides some support for using single item questions to identify those who need more in-depth assessment, and those who don’t need this level of attention. I like that! The idea that we can triage those who probably don’t need the whole toolbox hurled at them is a great idea. Perhaps the New Zealand politicians, as they begin the downhill towards general elections at the end of the year, could be asked to thoughtfully consider rational distribution of healthcare, and a greater emphasis on targeted use of allied health and expensive surgery.   Deyo, R. A., & Mirza, S. K. (2016). Herniated Lu...
Source: HealthSkills Weblog - May 28, 2017 Category: Anesthesiology Authors: adiemusfree Tags: Assessment Back pain Chronic pain Coping strategies Interdisciplinary teams News Pain conditions Professional topics Research biopsychosocial disability healthcare rehabilitation self management treatment Source Type: blogs

The Federal Pain Research Strategy - NIH
The Federal Pain Research Strategy is an effort of the Interagency Pain Research Coordinating Committee and the Office of Pain Policy of the National Institutes of Health to oversee development of a long-term strategic plan for those federal agencies and departments that support pain research. A diverse and balanced group of scientific experts, patient advocates, and federal representatives identified and prioritized research recommendations as a basis for this long-term strategic plan to coordinate and advance the federal pain research agenda. The key areas of prevention of acute and chronic pain, acute pain and acute pai...
Source: Psychology of Pain - May 26, 2017 Category: Anesthesiology Source Type: blogs

Thoughts On Creating EHRs That Clinicians Are Actually Reasonably Happy To Use And Don ’t Burn Them Out.
We had two relevant articles (and an extra) appear this week. First we had:Physicians dream up a better EHR May 22, 2017By Mary K. Pratt When the American Medical Association (AMA) last year announced study results that found physicians spend nearly half their office day entering data into electronic health records (EHRs) and handling other administrative deskwork, the organization said poorly designed EHRs were part of the problem. “If you were to start from scratch, you wouldn’t come up with the systems we have today,” said Jesse M. Ehrenfeld, MD, MPH, an associate professor of anesthesiology, surgery, ...
Source: Australian Health Information Technology - May 26, 2017 Category: Information Technology Authors: Dr David More MB PhD FACHI Source Type: blogs

How important are short AF episodes?
A study presented at the recent Heart Rhythm Society meeting in Chicago has added more uncertainty about the significance of short-duration AF episodes. Before I tell you about the study, I need to clarify what I mean by short-duration AF episodes, sometimes called subclinical AF (SCAF). SCAF is AF on a monitor that is often not felt by the patient. Doctors are seeing more of this because patients are increasingly being monitored–with pacemakers, ICDs, long-term event recorders and implantable cardiac monitors. These devices can pick up minute-long or hour-long AF episodes. In the past, AF could only be picked up whe...
Source: Dr John M - May 25, 2017 Category: Cardiology Authors: Dr John Source Type: blogs

Ketamine: A Miracle Drug for Depression?
A team of researchers funded by the National Institutes of Health (NIH) recently discovered why the drug ketamine may act as a rapid antidepressant. Ketamine is best known as an illicit, psychedelic club drug. Often referred to as “Special K” or a “horse tranquilizer” by the media, it has been around since the 1960s and is a staple anesthetic in emergency rooms and burn centers. In the last 10 years, studies have shown that it can reverse — sometimes within hours or even minutes — the kind of severe, suicidal depression that traditional antidepressants can’...
Source: World of Psychology - May 24, 2017 Category: Psychiatry & Psychology Authors: Therese J. Borchard Tags: Depression Medications Research addictive Bipolar Disorder dissociative anesthetic Drug Abuse Ketamine Major Depressive Disorder Mood Disorder Mood Stabilizer Selective Serotonin Reuptake Inhibitor Substance Abuse Source Type: blogs

There ’s no place for locker room talk in the OR
I am nearing the end of my training at one of the top surgical fellowships in the country. I chose this fellowship not just for the name, but also because the surgeons all seemed like genuine and altruistically motivated individuals. It was two-thirds of the way through fellowship when I found myself in conversation with two male trainees. We were discussing the younger trainee and his girlfriend; he would be moving away soon for fellowship, and they had decided to stay together. He mentioned that he had been operating with our program director earlier, and the topic had come up. When he told our program director that he w...
Source: Kevin, M.D. - Medical Weblog - May 23, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/anonymous" rel="tag" > Anonymous < /a > Tags: Physician Surgery Source Type: blogs

FDA Public Meeting on Training Health Care Providers on Pain Management and Safe Use of Opioid Analgesics
In 2012, FDA instituted a risk evaluation and mitigation strategy (REMS) for extended-release and long-acting (ER/LA) opioids that required companies marketing ER/LA opioids to provide a medication guide and make training available to prescribers. Under the REMS, the training must be provided by accredited providers and cover all elements of the agency's Blueprint for Prescriber Education for Extended-Release and Long-Acting Opioid Analgesics. However, while the agency set goals for prescriber participation, prescribers were not required under the REMS to go through with the training. On May 9th and 10th, 2017, the ...
Source: Policy and Medicine - May 23, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

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 article...
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 Kit De...
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

“ 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 so...
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