Managed Care Companies Should Publish Lessons Learned From Studying Their Own Big Data
In this era of big data, managed care companies have comprehensive data sets from which to extrapolate and report precise and meaningful findings about health services. With pay-for-performance models championed by the Affordable Care Act and pursued by the Centers for Medicare and Medicaid Services, the value and relevance of these data in improving health is likely greater than ever. That is why we agree that managed care companies have an imperative to participate in quality improvement initiatives, conduct rigorous, transparent research with our data, and widely share and disseminate those findings so that others may l...
Source: Health Affairs Blog - August 18, 2017 Category: Health Management Authors: Stuart L. Lustig and Liana D. Castel Tags: Diffusion of Innovation Featured Insurance and Coverage Population Health Quality big data health services research managed care companies peer-reviewed studies quality improvement initiatives Source Type: blogs
5 ways to make dealing with death easier
My husband, the anesthesiologist, came home one evening, he was solemn, affected, not himself. His patient died in the recovery room. It was sudden and unexpected for my husband. 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-old man with significant congestive heart failure, probably chronic kidney disease, and complete occlusion of one of his carotids who sustained hip fracture and thus required the surgery to pin his hip for both healing and comfort. This is the ultimate catch-22 in medicine (or at least in geriatric...
Source: Kevin, M.D. - Medical Weblog - July 19, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/shannon-tapia" rel="tag" > Shannon Tapia, MD < /a > Tags: Physician Geriatrics Palliative care Source Type: blogs
An interesting finding, and absence of another, in an intoxicated patient found down
CONCLUSION: Administration of subcutaneous terbutaline obviates the need for intravenous access and should be considered as an alternative to nebulized or inhaled beta-agonists to treat acute hyperkalemia in patients with CKD. As with the use of any beta-adrenergic agonist, close cardiovascular monitoring is necessary to avoid or minimize toxicity during therapy.Hypokalemic effects of intravenous infusion or nebulization of salbutamol in patients with chronic renal failure: comparative study.AULiou HH, Chiang SS, Wu SC, Huang TP, Campese VM, Smogorzewski M, Yang WC SOAm J Kidney Dis. 1994;23(2):266. To exami...
Source: Dr. Smith's ECG Blog - July 1, 2017 Category: Cardiology Authors: Steve Smith Source Type: blogs
Search strategy for chronic kidney disease
Chronic kidney disease? Chronic kidney failure? Chronic renal failure?There are many ways to describe this (1). After a few searches on the topic, I tried to come up with a Medline strategy. I think it may include some conditions that Hsu and Chertow would not, but I have this:1. ((endstage or “end stage” or established or chronic or progressive) adj1 (renal or kidney) adj1 (failure or disease* or insufficienc*)).ti,ab2. (Chronic adj1 nephropath*).ti,ab3. &nb...
Source: Browsing - April 21, 2017 Category: Databases & Libraries Tags: literature searching nephrology Source Type: blogs
Evidence for Senescent Cells to Promote Vascular Calcification
The progressive stiffening of blood vessels is an important proximate cause of age-related hypertension and cardiovascular disease. One cause of this stiffening is a process of calcification, deposition of calcium into the tissues of blood vessel walls. Recent evidence shows that this process is caused by changes in cellular behavior, which opens up a range of potential targets for therapy and prevention. Here, researchers further demonstrate that the activities of senescent cells are probably involved in this picture. This is good news if validated, as targeted clearance of senescent cells as an approach to the treatment ...
Source: Fight Aging! - March 13, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Investigating the Mechanisms of Slowed Kidney Fibrosis via Calorie Restriction
The objective of CRM research is to identify compounds that mimic the effects of CR by targeting metabolic and stress response pathways affected by CR without actually restricting caloric intake.
With respect to how short-term CR and CRM treatment might directly impact cellular senescence and EMT, one interesting candidate is the AMPK-mTOR signaling pathway. In the in vivo experiments, we demonstrated that AMPK/mTOR signaling in kidney was downregulated with age, and that this was reversed by short-term CR and CRM treatment. In order to further verify this pathway, we induced EMT and cellular senescence of proximal...
Source: Fight Aging! - February 28, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
MKSAP: 55-year-old man with gout
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 55-year-old man is evaluated during a follow-up visit for gout. Two years ago, he had been treated with allopurinol and developed a hypersensitivity reaction. Over the past several months, he has had recurrent attacks of acute, episodic swelling of the first metatarsophalangeal joints with increasing involvement of other joints, including the ankles and knees. Laboratory studies showed significant hyperuricemia. History is also significant for Crohn disease, hypertension, chronic kidney disease (estimated glom...
Source: Kevin, M.D. - Medical Weblog - February 25, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Rheumatology Source Type: blogs
Targeting PAD4 Reduces Age-Related Fibrosis
Fibrosis is the inappropriate formation of scar-like tissue, and it is an important component in the pathology of a range of age-related diseases. Fibrosis causes loss of function where it disrupts the normal tissue structure of organs, and at present there is little in the medical toolkit that can be used to help. Better known examples of conditions in which fibrosis is significant include the progression of chronic kidney disease and damage to aged heart tissue. Here researchers note the possibility for an intervention that slows down the progression of fibrosis in mice, and may form the basis for a human therapy:
...
Source: Fight Aging! - January 31, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs
Coronary artery disease: Primary care and prevention – 4
Previous
Prevention of CAD
Prevention is classified into primordial, primary and secondary. Primordial prevention is community level intervention to reduce risk factors and mostly not under the purview of the individual physician. Primary prevention is by controlling the risk factors.
Non modifiable risk factors for CAD
Age, gender, race/ethnicity and genetic predisposition or family history are considered the non modifiable risk factors for CAD. Prevalence of CAD increases as age advances and it is definitely more common in males. A strongly positive family history of premature coronary artery disease increases the risk ...
Source: Cardiophile MD - December 20, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Source Type: blogs
Short Quiz on radio contrast (iodinated ‘ dye ’ )
Short quiz on contrast used for angiography.
Quiz on radiocontrast
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Question 1Iodixanol is a —- radiocontrast:AIso-osmolar...
Source: Cardiophile MD - December 9, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Reduced ATF4 Slows the Progression of Vascular Calcification in Mice
In this study, we demonstrate that ATF4 expression in VSMCs plays a causative role in the pathogenesis of vascular calcification using a series of mouse models. As an initial model, we used global ATF4-haploinsufficient mice, which showed significantly smaller aortic medial calcified lesions under both CKD and normal kidney condition (NKD) conditions. We also used an SMC-specific ATF4-deficient model, in which both medial and atherosclerotic calcifications under NKD and CKD conditions were attenuated. Finally, we generated a mouse model that overexpresses ATF4 only in SMCs, in which severe medial and atherosclerotic calcif...
Source: Fight Aging! - November 7, 2016 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
Predictors of contrast induced AKI – Cardiology MCQ
Predictors of contrast induced acute kidney injury:
a) Estimated glomerular filtration rate (eGFR)
b) ST elevation myocardial infarction (STEMI)
c) Cardiogenic shock
d) All of the above
e) None of the above
Correct answer: d) All of the above
These are also the strongest predictors of AKI requiring dialysis. Roxana Mehran and associates developed a comprehensive risk prediction score which included age, hemoglobin level, pre-existing chronic kidney disease, volume of contrast administered during the percutaneous intervention, need for IABP (intra aortic balloon counterpulsation) and a few other variables. Presen...
Source: Cardiophile MD - October 31, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Launch! at Health 2.0
By MATTHEW HOLT
Launch! is always one of the most fun and most exciting sessions at Health 2.0. Ten new companies demo their product on stage for the very first time during at the 10th Annual Fall Conference. Previous Launch! winners have included Castlight Health, Basis, and OM*Signal and last year’s winner MedWand, which just beat out Gliimpse–itself since bought by Apple.
This year’s finalists are:
Valeet Healthcare‘s platform gives patients personalized health information while allowing providers to have a rounding tool and giving healthcare systems a dashboard to track metrics.
gripAble is...
Source: The Health Care Blog - September 14, 2016 Category: Consumer Health News Authors: Matthew Holt Tags: Health 2.0 THCB Albeado cricket health DayTwo Docent Health gripable Launch! MDwithMe Quizda Regeneration Health Siren Care Valeet Healthcare Source Type: blogs
Fight Aging! Newsletter, September 12th 2016
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more.
This content is...
Source: Fight Aging! - September 11, 2016 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs
A Cellular Cause for Calcification of Blood Vessels
The publicity materials and paper linked below discuss the identification of a cell type and related mechanisms responsible for calcification of blood vessels. The focus is on the environment of kidney disease, and thus on kidney tissue, but we might hope that this has a broader relevance to the age-related calcification that occurs in all blood vessels over the years. The more that is known of blood vessel calcification, the better the odds that something might be done about it soon enough to matter for you and I. The deposition of calcium in blood vessel walls is considered to be an important contribution to the loss of ...
Source: Fight Aging! - September 8, 2016 Category: Research Authors: Reason Tags: Medicine, Biotech, Research Source Type: blogs
