BioethicsTV (January 27-31, 2020)
by Craig Klugman, Ph.D.
The Good Doctor (Season 3; Episode 13): Making emotional decisions regarding cancer care; New Amsterdam (Season 2; Episode 12): Withdrawing ANH in PVS; Treating the Physical to Heal the Mental
The Good Doctor (Season 3; Episode 13): Making emotional decisions regarding cancer care
Reznick’s mother is dying of brain cancer. She is an artist and is unwilling to do any treatments that will affect her ability to create art. When her mother becomes unconscious and has a brain bleed, Reznick chooses a brain surgery to remove part of the brain that is bleeding rather than the full tumor removal that her...
Source: blog.bioethics.net - February 6, 2020 Category: Medical Ethics Authors: Craig Klugman Tags: BioethicsTV End of Life Care Featured Posts Professionalism Psychiatric Ethics Source Type: blogs
Using Ultrasound for Paracentesis
Paracentesis can be a quick and simple procedure with the right equipment and a well-rehearsed approach. It's important to practice this skill in the procedure lab and to familiarize yourself with the kit in your department a few times a year. This month, we focus on paracentesis set-up and basics, and next month we will review the nuts and bolts of completing the procedure.Important equipment for paracentesis: Five or six collection bottles, antiseptic prep, and a paracentesis kit. Consider longer needles for abdominal walls thicker than 2.5 cm.Grab the ultrasound and a pen. Position your patient at a 45-degree ang...
Source: The Procedural Pause - February 3, 2020 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
LDL cholesterol: How low can you (safely) go?
In this study, there was no increased risk of adverse outcomes (including muscle aches, liver dysfunction, new onset of diabetes, cancer, and bleeding strokes), even when LDL was lowered to as low as 20 mg/dL. Although statin medications themselves have been linked to side effects, especially at high doses, it appears that extremely low LDL concentrations are not responsible for side effects.
In other words, lowering LDL beyond our previous target of 70 mg/dL appears to be not only safe but beneficial, in patients with CVD.
The post LDL cholesterol: How low can you (safely) go? appeared first on Harvard Health Blog. (Sourc...
Source: Harvard Health Blog - January 20, 2020 Category: Consumer Health News Authors: Dara K. Lee Lewis, MD Tags: Drugs and Supplements Health Heart Health Source Type: blogs
Long-Term Effect of Binge Drinking on the Body
Most people know about the damaging effects that binge drinking can bring to someone’s life. Loss of enjoyment of life, losing family relationships, financial and career struggles, homelessness, and legal consequences are just the tip of the iceberg. However, it can be more difficult to realize the long-term effect of binge drinking on the body, because you cannot always see it. Frequent binge drinking poses many dangerous health risks, and many of them can lead to death.
Facts on Long-Term Effect of Binge Drinking on the Body
For men, binge drinking is defined as consuming five or more drinks within about two hours, a...
Source: Cliffside Malibu - January 17, 2020 Category: Addiction Authors: Jaclyn Uloth Tags: Alcohol Alcohol Rehab Information Alcoholism alcohol abuse alcohol dependence alcohol treatment alcohol treatment center binge binge drinking Source Type: blogs
Diabetic retinopathy: Understanding diabetes-related eye disease and vision loss
Over 30 million people in the United States live with diabetes, and approximately 7.7 million people have diabetic retinopathy, making it the most common cause of vision loss in working-aged adults. The prevalence of diabetic retinopathy has increased significantly over the past 20 years, due to the rise in the number of people diagnosed with diabetes.
How does diabetes affect the retina?
The retina is the light-sensing component located in the back of the eye. It is composed of blood vessels, nerve cells (neurons), and specialized cells called photoreceptors that are involved in directly sensing light. The ability of the ...
Source: Harvard Health Blog - January 16, 2020 Category: Consumer Health News Authors: Leo Kim, MD, PhD Tags: Diabetes Eye Health Source Type: blogs
Podcast: Transforming Trauma Into Wholeness and Healing
Trauma eventually comes for all of us. It isn’t just stereotypical things like war or assault that are traumatic, there is also the everyday realities of things like illness or job loss. As painful as it is, trauma can be an invitation to a process of growth and change.
Join us as today’s guest, Dr. James Gordon, explains some of the techniques of trauma healing, including some surprising ones, like laughter and spending time with animals. Dr. Gordon also shares with us how he personally handles his own trauma and the programs most often used by the Center for Mind-Body Medicine.
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Guest ...
Source: World of Psychology - January 9, 2020 Category: Psychiatry & Psychology Authors: The Psych Central Podcast Tags: General Interview Mental Health and Wellness The Psych Central Show Trauma Source Type: blogs
Reference Manuals May Be Facing Obsolescence
We must ensure their relevance to contemporary patient care
By LONNY REISMAN, MD
It’s 1992 and disruptive technologies of the day are making headlines: AT&T releases the first color videophone; scientists start accessing the World Wide Web; Apple launches the PowerBook Duo.
In healthcare, with less fanfare, a Harvard physician named Dr. Burton “Bud” Rose converts his entire nephrology textbook onto a floppy disk, launching the clinical tool that would ultimately become UpToDate. Instead of flipping through voluminous medical reference texts, such as the Washington Manual, doctors could for the first ...
Source: The Health Care Blog - December 27, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Health Tech Health Technology Physicians Evidence Based Medicine Guidelines Lonny Reisman reference manuals UptoDate Source Type: blogs
A new look at steroid injections for knee and hip osteoarthritis
Osteoarthritis is a common and potentially debilitating condition. It’s a degenerative joint disease (often called the “wear-and-tear” type) in which the smooth lining of cartilage becomes thinned and uneven, exposing the bone beneath.
Although osteoarthritis is tightly linked with aging, we now know there is more to it than age alone: genetics, weight, physical activity, and a number of other factors can conspire to make it more likely that someone will develop osteoarthritis while someone else won’t. Osteoarthritis is the primary reason that more than a million joints (mostly hips and knees) are replaced each yea...
Source: Harvard Health Blog - December 23, 2019 Category: Consumer Health News Authors: Robert H. Shmerling, MD Tags: Arthritis Osteoarthritis Pain Management Source Type: blogs
Switching to Outpatient Surgery for Everyone ’s Benefit
By AMY KRAMBECK, MD
The
trend toward less invasive procedures, shifting from inpatient to outpatient, has
changed the face of surgery. Industry-changing leaps in technology and surgical
techniques have allowed us to achieve our treatment goals with smaller
incisions, laparoscopy and other “closed” procedures, less bleeding, less pain,
and lower complication rates. As a result, patients who used to require days of
recovery in the hospital for many common surgeries can now recuperate in their
own homes.
Outpatient
procedures grew from about 50% to 67% of hospitals’
total surgeries between 1994 and 2016,1,2 and o...
Source: The Health Care Blog - December 19, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Amy Krambeck benign prostatic hyperplasia outpatient surgery Source Type: blogs
DOACs now recommended over warfarin to prevent blood clots in people with atrial fibrillation
For decades, warfarin (Coumadin) was the standard anticoagulant medication used to prevent blood clots, which can lead to stroke, in people with atrial fibrillation (afib). Direct oral anticoagulants (DOACs), sometimes called novel oral anticoagulants (NOACs), are a new type of anticoagulant medication that came on the market in 2010.
In 2019, the American Heart Association/American College of Cardiology/Heart Rhythm Society (AHA/ACC/HRS) updated their afib guidelines to strongly recommend using DOACs over warfarin in people with afib.
Warfarin is effective, but has downsides
Afib is a condition in which the upper chambers...
Source: Harvard Health Blog - December 16, 2019 Category: Consumer Health News Authors: Peter Zimetbaum, MD Tags: Drugs and Supplements Heart Health Source Type: blogs
Fight Aging! Newsletter, December 16th 2019
This study shows that CA are released from periventricular and subpial regions to the cerebrospinal fluid and are present in the cervical lymph nodes, into which cerebrospinal fluid drains through the meningeal lymphatic system. We also show that CA can be phagocytosed by macrophages. We conclude that CA can act as containers that remove waste products from the brain and may be involved in a mechanism that cleans the brain. Moreover, we postulate that CA may contribute in some autoimmune brain diseases, exporting brain substances that interact with the immune system, and hypothesize that CA may contain brain markers that m...
Source: Fight Aging! - December 15, 2019 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
A Large Study of Aspirin Use Finds Reduced Mortality, Contradicting the Recent ASPREE Study Results
The back and forth over whether regular aspirin use is beneficial continues with the publication of results from analysis of a large patient population that show a 15% reduction in all cause mortality in patients using aspirin. This contradicts the much smaller (but still large in and of itself) ASPREE clinical trial, in which patients using aspirin exhibited a small increase in mortality in comparison to their peers. As in that earlier study, the data here strongly suggests that benefits and risks vary with patient characteristics, such as whether or not a patient is overweight.
Aspirin is thought to be a weak calo...
Source: Fight Aging! - December 13, 2019 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Treating Fingertip Amputations
Fingertip injuries and amputations are common in the emergency department, often occurring on weekends when consultants are not available. Some experienced physicians may consider rongeuring distal tuft amputation injuries, but simple closure and expert consultation for more difficult cases are suggested.A fingertip amputation within zone III involving total amputation of the distal tip, fingernail, matrix, and tuft. Photos by M. Roberts.Care of fingertip amputations in the ED should focus on removing debris and cleaning the wound as best as possible, closing the wound using available skin, bandaging and splinting for c...
Source: The Procedural Pause - December 5, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
VISTASEAL Fibrin Sealant to Quickly Stop Surgical Bleeds
Ethicon, a part of J&J, is releasing a new surgical fibrin sealant designed to be delivered much faster than existing options. The VISTASEAL Fibrin Sealant helps to control unexpected bleeding thanks to its chemical composition and delivery mechanism, which work together to quickly get to the bleed site and achieve hemostasis faster.
VISTASEAL contains fibrinogen and thrombin, two clotting proteins that are naturally present in blood plasma. These help the material to produce clots quickly and with high reliability.
The product can be used during open procedures, and thanks to two optional extension tips it c...
Source: Medgadget - December 4, 2019 Category: Medical Devices Authors: Medgadget Editors Tags: Emergency Medicine Surgery Source Type: blogs
New Portable MRI Could Change the Way We Approach Emergency Imaging
Jonathan Rothberg, an entrepreneur with a knack for developing creative solutions for imaging needs, is adding a portable MRI scanner about the size of a photo booth to his growinglistof accessible imaging inventions. The scanner was spun out of Rothberg ’s latest startup, Hyperfine. According to STAT News, the MRI is priced around $50,000, it ’s 20 times cheaper to build than traditional MRI, 10 times lighter, and consumes 35 percent less energy than a 1.5 Tesla MRI. It was designed for emergency situations, and can be easily wheeled around and patients don’t need to remove any metal accessories to use it. Ke...
Source: radRounds - November 15, 2019 Category: Radiology Authors: Julie Morse Source Type: blogs
