In-person clinic visits are being replaced with virtual visits at a rapid pace
From the NEJM:What if health care were designed so that in-person visits were the second, third, or even last option for meeting routine patient needs, rather than the first?At Kaiser Permanente, 52% of 100 million patient encounters each year are now “virtual visits”. It spends 25% of its annual $3.8 billion budget on information technology."Payment models are an obvious barrier to deemphasizing in-person visits, but every provider ’s business success depends on market share. The best way to win market share is to design and deliver better care, then modify the payment system to support it. Moreover, payment systems...
Source: Clinical Cases and Images - Blog - January 16, 2018 Category: Universities & Medical Training Tags: NEJM Technology Source Type: blogs
Smartphone and Social Media Use in Lectures Makes Your Learn Less
Several studies have shown that problematic smartphone use (PSU) is related to detrimental outcomes, such as:- worse psychological well-being- higher cognitive distraction- poorer academic outcomesProblematic smartphone use (PSU) is strongly related to social media use.The study participants were 415 Estonian university students aged 19-46 years (79% females).Problematic smartphone use (PSU) and the frequency of social media use in lectures were negatively correlated with a deep approach to learning (defined as learning for understanding) and positively correlated with a surface approach to learning (defined as superficial...
Source: Clinical Cases and Images - Blog - January 15, 2018 Category: Universities & Medical Training Tags: Education Social Media Source Type: blogs
How to treat dry eyes
How common are dye eyes?The prevalence of dry eyes has been estimated to be 5-30% percent in persons aged 50 years and older, 7% of US adult population has been diagnosed with dry eye disease. The prevalence increases with age (2.7% in those 18 to 34 years old vs. 19% in those aged 75 years and older). Prevalence is higher in women than men (9% versus 4%).What are the risk factors for dry eye disease?- Advanced age- Female gender- Hormonal changes (primarily due to decreased androgens)- Systemic diseases (eg, diabetes mellitus, Parkinson disease)- Contact lens wear- Systemic medications (antihistamines, anticholinergi...
Source: Clinical Cases and Images - Blog - January 2, 2018 Category: Universities & Medical Training Authors: noreply at blogger.com (Ves Dimov) Tags: Ophthalmology Source Type: blogs
Major Success for Gene Therapy for Factor IX Deficiency: near elimination of bleeding and factor use
Hemophilia B Gene Therapy with a High-Specific-Activity Factor IX Variant: the researchers infused a single-stranded adeno-associated viral (AAV) vector consisting of a bioengineered capsid, liver-specific promoter and factor IX Padua (factor IX –R338L) transgene in 10 men with hemophilia B who had factor IX coagulant activity of 2% or less of the normal value.They found sustained therapeutic expression of factor IX coagulant activity after gene transfer in the 10 participants with hemophilia who received the same vector dose. Transgene-derived factor IX coagulant activity enabled the termination of baseline prophylaxis ...
Source: Clinical Cases and Images - Blog - January 1, 2018 Category: Universities & Medical Training Tags: Hematology NEJM Source Type: blogs
The large mouth of largemouth bass is of interest to scientists trying to understand how joints work
Inside the bass ’s mouth is a system of linked muscle and bone that resembles the mechanism of an oil rig. NYTimes:Read more here:https://www.nytimes.com/2017/12/26/science/largemouth-bass-jaw.html?smid=tw-share
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Source: Clinical Cases and Images - Blog - December 30, 2017 Category: Universities & Medical Training Tags: Anatomy NYTimes Orthopedics Rheumatology Source Type: blogs
Fremanezumab for Preventive Treatment of Migraine
Fremanezumab is a humanized monoclonal antibody targeting calcitonin gene –related peptide (CGRP). It is administered monthly via SQ injection.In this NEJM study, fremanezumab was effective as a preventive treatment for chronic migraine:http://www.nejm.org/doi/full/10.1056/NEJMoa1709038
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Source: Clinical Cases and Images - Blog - December 29, 2017 Category: Universities & Medical Training Tags: Neurology Source Type: blogs
Genetics-based app could help you find true love
The first genetics-based dating app, called Pheramor, is expected to launch in 2018. The name is based on pheromones:https://pheramor.com/pheramor-kit/The founders say: "Genetic-based human attraction has to do with pheromones. And when we smell pheromones, what we're actually smelling is how diverse someone's immune system is compared to our own.""Evolution is very strong. So we're smelling each other, trying to figure out who is the best person to mate with. And that's what love at first sight actually is. It's smelling someone's pheromones from across the room, and your brain says, "That's the most perfect pheromone pro...
Source: Clinical Cases and Images - Blog - December 27, 2017 Category: Universities & Medical Training Tags: Genetics Source Type: blogs
BMJ study: Patients treated by older physicians (60 and older) had higher mortality vs. younger physicians (39 and younger)
FromBMJ:The researchers evaluated a 20% random sample of Medicare fee-for-service beneficiaries aged 65 and older admitted to hospital with a medical condition in 2011-14 and treated by hospitalist physicians.Main outcome measures 30 day mortality and readmissions and costs of care.The study included 700,000 admissions managed by 18,800 hospitalist physicians (median age 41).Patients ’ adjusted 30 day mortality rates were:- 10.8% for physicians younger than 40- 11.1% for physicians aged 40-49- 11.3% for physicians aged 50-59- 12.1% for physicians aged 60 and olderSee the figure here:http://www.bmj.com/content/bmj/357/bmj...
Source: Clinical Cases and Images - Blog - December 13, 2017 Category: Universities & Medical Training Tags: Age Geriatrics Physician Source Type: blogs
Surgeon grows vegetables across from his hospital to cope with stress and burnout
From thisReuters/Yahoo article:"Dr. Brian Halloran, a vascular surgeon at St. Joseph Mercy Ann Arbor, starts planning his garden long before spring arrives in southeast Michigan. His tiny plot, located in the shadow of the 537-bed teaching hospital, helps Halloran cope with burnout from long hours and the stress of surgery on gravely ill patients. "You really have to find the balance to put it a little more in perspective," he said.Hospitals such as St. Joseph Mercy Ann Arbor have been investing in programs ranging from yoga classes to personal coaches designed to help doctors become more resilient. But national burnout ra...
Source: Clinical Cases and Images - Blog - November 22, 2017 Category: Universities & Medical Training Tags: Burnout Physician Psychology Stress Source Type: blogs
How to fight physician burnout - KevinMD shares his personal experience
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Source: Clinical Cases and Images - Blog - September 26, 2017 Category: Universities & Medical Training Tags: Psychology Source Type: blogs
Mosquito controls with AGO bucket traps, Autocidal Gravid Ovitrap (AGO), tested by CDC
Autocidal Gravid Ovitrap (AGO) bucket trap is a standard 5-gallon bucket adapted in a specific way to capture mosquitoes.AGO traps are available for purchase online from Springstar. Two traps cost $75, free shipping:https://www.springstar.net/collections/mosquitoes/products/agoThe Autocidal Gravid Ovitrap (AGO trap), was developed by the Center for Disease Control (CDC) and has been proven to reduce populations of Aedes mosquitoes by over 80%. It is effective for the mosquitoes that transmit Zika, dengue, chikungunya, and yellow fever. No pesticides or pheromones required. Just add water and a little hay.From Springstar we...
Source: Clinical Cases and Images - Blog - September 24, 2017 Category: Universities & Medical Training Authors: noreply at blogger.com (Ves Dimov) Tags: Florida Infectious Diseases Tropical Source Type: blogs
Who are the doctors who don't get stressed at work? Check if you have the personality type
Who are the doctors who don't get stressed at work? According to this meta-analysis, the personality type to have is:extravert who is open to experience and has a deep learning style. If you are this type, congratulations! If not, read below, and be sure to check the references at the end.The Big Five personality inventory measures personality based on 5 key traits:1. neuroticism2. extraversion3. agreeableness4. openness to experience5. conscientiousnessThere areseveral approaches to work (SSD):-Surface-disorganised approach is apparently the worst, and is predicted by surface learning in medical school and by hi...
Source: Clinical Cases and Images - Blog - June 21, 2017 Category: Universities & Medical Training Tags: Psychology School Source Type: blogs
Unprecedented range of therapeutic options for rheumatic diseases is now available — challenge is to make them accessible
From The Lancet:Small molecule inhibitors of Janus kinase (JAK)Much of the recent knowledge of the underlying mechanisms that drive rheumatoid arthritis and other diseases has come from preclinical studies of key cytokines, including tumour necrosis factor alpha, interleukin 6, and granulocyte –macrophage colony-stimulating factor. New Janus kinase (JAK) inhibitors include tofacitinib and baricitinib which are approved for treatment of arthritis and other rheumatoid diseases.Aggressive treatment, earlyFor a complex, progressive, chronic disease such as rheumatoid arthritis, the timing of intervention is critical. In...
Source: Clinical Cases and Images - Blog - June 12, 2017 Category: Universities & Medical Training Tags: Rheumatology Source Type: blogs
Get Ready for Your Next Meeting With the Boss –at the Gym
From WSJ: As an alternative to meetings, buff bosses are inviting their employees to exercise and work out (video):Some prospective employers ask baffled applicants to take jogs, lift weights or do sit-ups; ‘I thought I was going to pass out’, says one job applicant. Read more in WSJ here: Thanks for Your Job Application—Shall We Begin at the Squat Rack?http://buff.ly/2qNEG24
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Source: Clinical Cases and Images - Blog - June 2, 2017 Category: Universities & Medical Training Tags: Sports WSJ Source Type: blogs
How to live to 100: avoid "major agers", choose foods that love you back
The one and only Dr. Roizen shares tips for Living to 100, using some memorable buzz words, among them:- avoid the "major agers" of stress and lack of sleep- have a relationship with your food - choose foods that "love you back"Here is the Cleveland Clinic Chief Wellness Officer, Mike Roizen, M.D.:
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Source: Clinical Cases and Images - Blog - June 2, 2017 Category: Universities & Medical Training Tags: Cleveland Clinic Source Type: blogs
