Two AF cases — and my changing view of AF
I receive many emails about AF. I don’t often answer them because it is bad practice to doctor without seeing the person. Recently, however, I received a note with more general questions. The sender suggested I could use the response as a blog post. The reason I am posting these two cases along with my response is that my views on AF are changing. I am in the process of putting these global thoughts on AF together as a more general update, but these cases are a start.
Here is the email from a reader: (a doctor).
Dear John,
What would you recommend?
My med school roommate and I are 69 years old and in good health, nor...
Source: Dr John M - August 4, 2014 Category: Cardiology Authors: Dr John Source Type: blogs
Facebook Activity Earns Zarbee's a Slap on the Wrist from FDA
The FDA continued their focus on social media by coming down on Zarbee's for activity on the company’s Facebook page. Zarbee's, a company focusing on natural cough remedies for young children, received a letter from the FDA outlining transgressions within (relatively) recent social media activity. The letter specifically focused on Facebook activity including likes on certain comments as well as two tweets from earlier this year. Most of the highlighted activity took place in January and February of this year although two posts from October 2013 are mentioned as well. Some of the specific posts ci...
Source: ePharma Summit - July 14, 2014 Category: Medical Marketing and PR Tags: #epharma ePharma Summit epharma West FDA Social Media FDA Social media guidance FDA social media guidelines Zarbees Zarbees Facebook Zarbees FDA Source Type: blogs
Rapid Growth of Urgent Care Clinics; Cost Competition for Hospital ERs
I have posted a number of notes about walk-in health clinics which are usually located in chain drug stores and staffed by nurse practitioners (NPs). The business model for them is to treat routine minor problems. A recent article discussed the rapid growth of urgent care clinics, many of which are attracting venture capital funding (see: Race Is On to Profit From Rise of Urgent Care). These latter facilities, in comparison to walk-in clinics, are staffed by physicians and offer a wider range of services. A recent article raised the issue of how to understand the mission and scope of services of urgent care facilitie...
Source: Lab Soft News - July 11, 2014 Category: Pathologists Authors: Bruce Friedman Tags: Health Insurance Healthcare Business Healthcare Delivery Hospitals and Healthcare Delivery Medical Consumerism Quality of Care Source Type: blogs
Hemoptysis Pearls
There was a nice article over at Consultant360.com by Drs. Laren Tan and Samuel Louie on hemoptysis pearls. Learned quite a few things.
200 mls of blood (about a cupful) is enough to fill the dead space in the lungs and is therefore generally considered the minimum amount of blood to make the diagnosis of “massive” hemoptysis.
Hemoptysis with chest pain – think pneumonia/pleurisy, PE with pleurisy, pulmonary edema from an MI, or lung cancer
Hemoptysis with dyspnea – think either exacerbation of patient’s underlying medical problem or a precursor to respiratory failure
Hemoptysis with fever ...
Source: WhiteCoat's Call Room - June 26, 2014 Category: Emergency Medicine Authors: WhiteCoat Tags: Medical Topics Source Type: blogs
Stop Expecting Antibiotics to Be Handed Out Routinely: Here’s Why
For years, my colleagues on the Prepared Patient site have preached the importance of being an advocate for your own care. And they’ve noted that at times it is necessary to push back against doctors’ recommendations if a suggested treatment does not seem right. I just returned from a visit to the U.K., which drove home the importance of that advice. Coming down with a common cold gave me a chance to experience differences in how British and American doctors approach the nasty symptoms of an all-too-common medical problem.
Let’s face it. Most of us have been given too many antibiotics for sore throats, co...
Source: Disruptive Women in Health Care - June 16, 2014 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Access Consumer Health Care Policy Source Type: blogs
Les Izmore
A couple of interesting, or should I say egregious items in this week's medical journals. (You'll probably just get the abstracts, if that.)Barnett and Linder proffer a research letter to JAMA which quite frankly baffles me. We have known for decades that antibiotics are not effective for acute bronchitis. CDC and others have been working to reduce antibiotic prescribing for acute bronchitis, and the leading quality measurement system, the Healthcare Effectiveness Data and Information Set metric is that antibiotic prescribing for acute bronchitis should be zero. Zip, zilch, nada. Don't do it, doc!And yet, and yet . . ...
Source: Stayin' Alive - May 22, 2014 Category: American Health Source Type: blogs
Simple Enough Goals You Would Think
I just got over being sick, or at least am much better. Stupid asthma and bronchitis! My doctor put me on prednisone, a steroid. All the side effects he said I would have, it turned out to be completely opposite. He said I would feel cranked up, but I felt extremely weak. Not cranky like he said, but a bit more aggressive than normal. And these weird hot flash sensations. Not looking forward to menopause, that was uncomfortable!My mood seems to be better. I took myself down from 80mg of Latuda to 40 because I was wondering if that had increased my appetite so drastically. I have probably gained 15-20 pounds now and really,...
Source: bipolar.and.me - March 7, 2014 Category: Mental Illness Source Type: blogs
Health Wonk Review, post-HIMSS
While all the health IT reporters like myself were in Florida last week for HIMSS14, plenty of other things were going on in healthcare. David Harlow of HealthBlawg has a roundup of opinions in the latest edition of Health Wonk Review, entitled “In Like a Lion.”
Yes, HIMSS was a big deal, even for non-IT people, as I captured the top mention in a HWR for, I believe, the very first time, with my podcast interview with HIMSS President and CEO Steve Lieber.
(David, per your note, I only suffered superficial injuries this year, with a couple of scrapes on my face. No stitches needed, and no deaths in my family, tho...
Source: Neil Versel's Healthcare IT Blog - March 3, 2014 Category: Technology Consultants Authors: Neil Versel Tags: blogging Blue Button health IT health reform Health Wonk Review Healthcare IT HHS HIMSS HIPAA media ONC Patient Protection and Affordable Care Act patient safety personal notes Adam Dole Blue Button Connector HIMSS14 Kare Source Type: blogs
Pro vaccination campaign – Measles
There is a lot of #BS talked about the harm vaccines might cause, most of it unproven scaremongering by patient advocates, lawyers, quacks and tabloid journalists. There is almost a religion growing out of the antivax campaign that seems to walk hand-in-hand with conspiracy theory nonsense and the gibberish peddled by those who think governments shouldn’t advise us on what to do when it comes to health, even if it could save lives. Here are a few answers to the antivax brigade.
Child with measles rash – http://en.wikipedia.org/wiki/Measles – Deaths from measles are rare, but complications can occur, bron...
Source: Sciencebase Science Blog - February 10, 2014 Category: Medical Scientists Authors: David Bradley Tags: Science Source Type: blogs
Chronic Bronchitis and Chronic Obstructive Lung Disease Review
Although commonly thought of synonymous, or, at least, forming a spectrum, chronic bronchitis is distinct from COPD. This review focuses on the pathophysiology of chronic bronchitis and goblet cell hyperplasia and the association between small airways disease and worse outcomes... (Source: The Daily Sign-Out)
Source: The Daily Sign-Out - November 18, 2013 Category: Pathologists Authors: Mark D. Pool, M.D. Tags: Chronic Obstructive Lung Disease Lung Pathology Source Type: blogs
Critical Care Compendium update
LITFL’s Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Currently there are almost 1,500 entries with more in the works… Some pages are more developed than others, and all the pages are being constantly revised and improved. Links to new references and online resources are added daily, with an emphasis on those that are free and open access (FOAM!).
These pages originated from the FCICM exam study notes created by Dr Jeremy Fernando in 2011, and have been updated, modified and added to since. As such will be particularly us...
Source: Life in the Fast Lane - November 17, 2013 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Critical Care Compendium Education eLearning Emergency Medicine Featured CCC LITFL collection Source Type: blogs
You can now see your physician - on your SmartPhone
We all know that the growing cost of healthcare are causing some to cut back on their prescriptions. According to Take Part, this is because of several factors including cutting back on filling prescriptions which is a result of several things: fewer visits to the doctors office, fewer visits to the emergency room and outpatient clinics, and a less sever flu season. Some find this troubling as they have determined that many patients aren't going to the doctor when they need to.
Enter American Well. This company has made telehealth available and affordable to many Americans and has just opened up their se...
Source: ePharma Summit - October 17, 2013 Category: Medical Marketing and PR Tags: Telehealth Doctors visits ePharma Summit Digital Physicians Source Type: blogs
You can now see your physician - on your SmartPhone
We all know that the growing cost of healthcare are causing some to cut back on their prescriptions. According to Take Part, this is because of several factors including cutting back on filling prescriptions which is a result of several things: fewer visits to the doctors office, fewer visits to the emergency room and outpatient clinics, and a less sever flu season. Some find this troubling as they have determined that many patients aren't going to the doctor when they need to.Enter American Well. This company has made telehealth available and affordable to many Americans and has just opened up their serv...
Source: ePharma Summit - October 17, 2013 Category: Medical Marketing and PR Tags: Digital Physicians Doctors visits ePharma ePharma Summit Telehealth Source Type: blogs
Have Physicians Lost Their Backbone?
What ever happened to courage?
Jim came through the choleycystectomy beautifully. In fact, he did so well that in no time he was back on the basketball court. Three weeks later he was in my office with a sore, swollen leg. He thought it was from twisting his ankle the day before. And indeed, it had all the appearances of a sports injury. I examined the extremity carefully, and decided to get a venous doppler to evaluate for DVT given the recent surgery.
My suspicions were confirmed when the technician called to tell me that he had found a clot in the deep veins of the thigh. Shortly after hanging up, my phone started to ...
Source: In My Humble Opinion - October 10, 2013 Category: Family Physicians Authors: Jordan Grumet Source Type: blogs
Top stories in health and medicine, October 4, 2013
From MedPage Today:
‘Meaningful Use’ Still on Target During Shutdown. The government shutdown may be slowing or halting a number of health-related activities, but federal incentives for electronic health records aren’t one of them.
Inappropriate Antibiotic Use Still High. Despite years of persuasion and publicity, antibiotics are still drastically overprescribed for two common complaints — sore throat and bronchitis.
Fecal Transplant, Now in Pill Form. Gel caps containing concentrated fecal microbes stopped recurrent Clostridium difficile infection and were well-tolerated by recipients.
Higher Vit...
Source: Kevin, M.D. - Medical Weblog - October 4, 2013 Category: Family Physicians Tags: News GI Health IT Infectious disease Neurology Source Type: blogs
