Top stories in health and medicine, August 28, 2014
From MedPage Today:
I, Intern: Common Problems, Elusive Answers. Rebecca Karb, MD, crosses paths with patients in the Rhode Island Hospital emergency department who have ailments that she rarely saw as a medical student.
Results Mixed With Home BP Monitoring. A hypertension self-management program reduced systolic blood pressure in high-risk patients, including those with cardiovascular disease, diabetes, or chronic kidney disease.
Surgery No Help for Mild Knee OA. Arthroscopic surgery for degenerative meniscal tears in patients with mild knee osteoarthritis had no benefit for function or pain.
Study Flags ECG Change as ...
Source: Kevin, M.D. - Medical Weblog - August 28, 2014 Category: Journals (General) Authors: MedPage Today Tags: News Heart Orthopedics Source Type: blogs
Top stories in health and medicine, August 25, 2014
From MedPage Today:
Futile ICU Care for Some Delays Care for Others. Providing futile care to ICU patients delayed care for other patients awaiting transfer into the ICU, according to a 3-month study of ICU practices at two hospitals.
Lupus and the Atomic Bomb? In the early 1950s, with the expanding arms race of the Cold War, the U.S. Department of Energy chose a rural site in Fernald, Ohio, to build a uranium-processing plant that would supply the nation’s proliferating nuclear arsenal. Decades later, Fernald was a Superfund site following long-denied environmental contamination, and efforts to identify and analyz...
Source: Kevin, M.D. - Medical Weblog - August 25, 2014 Category: Journals (General) Authors: MedPage Today Tags: News Heart Rheumatology Source Type: blogs
ACE Inhibitors and anemia
: Angiotensin converting enzyme (ACE) inhibitors have been implicated in the worsening of anemia in patients with chronic kidney disease (CKD) on dialysis and renal transplant recipients. Both ACE inhibitors and angiotensin receptor blockers (ARB) have some effect on erythropoietin synthesis and can cause suppression of erythropoiesis in those with CKD. This can sometimes be overcome by escalating the dose of exogenously administered erythropoietin. It is known that activation of renin-angiotensin system enhances the production of erythropoietin in peritubular fibroblasts of the kidney. Some studies also suggest that ACE i...
Source: Cardiophile MD - August 23, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs
Mitral annular calcification (MAC)
Mitral annular calcification (MAC) is more likely in those with chronic kidney disease because of the deranged calcium and phosphorus metabolism. Products of calcium and phosphorus metabolism cause soft tissue calcification. MAC is also a marker of atherosclerotic burden. Mitral annular calcification is associated with higher incidence of atrial arrhythmias, stroke and cardiovascular mortality. MAC is more common in females, elderly and in those with hypertension and diabetes.
Mechanism of mitral regurgitation in MAC
Mitral annular calcification is more likely to cause mitral regurgitation than stenosis. Three reasons cou...
Source: Cardiophile MD - August 13, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Mitral stenosis due to mitral annular calcification Source Type: blogs
Mitral annular calcification (MAC)
Mitral annular calcification (MAC) is more likely in those with chronic kidney disease because of the deranged calcium and phosphorus metabolism. Products of calcium and phosphorus metabolism cause soft tissue calcification. MAC is also a marker of atherosclerotic burden. Mitral annular calcification is associated with higher incidence of atrial arrhythmias, stroke and cardiovascular mortality. MAC is more common in females, elderly and in those with hypertension and diabetes.
Mechanism of mitral regurgitation in MAC
Mitral annular calcification is more likely to cause mitral regurgitation than stenosis. Three reasons cou...
Source: Cardiophile MD - August 13, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Mitral stenosis due to mitral annular calcification Source Type: blogs
Living with Reduced Kidney Function
Just wanted to share this “Living with Reduced Kidney Function” guide I came across from Australia as I think it has very useful information for anyone dealing with chronic kidney disease. The focus of the guide is the practical steps patients can take to conserve their kidney function and slow down or halt degradation. (Source: All Kidney News)
Source: All Kidney News - August 12, 2014 Category: Urology & Nephrology Authors: admin Tags: Uncategorized Source Type: blogs
Top medicine articles for July 2014
A collection of some interesting medical articles published recently:Migraines Linked to Increased Risk of 'Silent Strokes' http://buff.ly/1hTE5RuDoctor’s Salaries Are Not the Big Cost - NYTimes http://buff.ly/QWe2lx -- "There is a startling secret behind America’s health care hierarchy: Physicians, the most highly trained members in the industry’s work force, are on average right in the middle of the compensation pack. That is because the biggest bucks are currently earned not through the delivery of care, but from overseeing the business of medicine.The base pay of insurance executives, hospital executives and...
Source: Clinical Cases and Images - Blog - July 23, 2014 Category: Universities & Medical Training Tags: Health News of the Day Source Type: blogs
Higher risk of AF with CKD linked to fibroblast growth factor 23
Fibroblast growth factor-23 (FGF-23) is hormone derived from the bone, which rises in chronic kidney disease (CKD) in an attempt to maintain proper phosphate homeostasis. FGF-23 enhances excretion of phosphate in urine and inhibits intestinal absorption of phosphate by reducing the production of 1,25-dihydroxycholecalciferol (1,25-dihydroxyvitamin D3). Analysis of data from The Multi-Ethnic Study of Atherosclerosis (MESA) and the Cardiovascular Health Study (CHS) has shown a link between FG-23 and atrial fibrillation [Mathew JS et al. Fibroblast Growth Factor-23 and Incident Atrial Fibrillation. Circulation. 2014; 130: 298...
Source: Cardiophile MD - July 22, 2014 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology AF atrial fibrillation Cardiovascular Health Study chronic kidney disease CKD FGF-23 Fibroblast growth factor-23 MESA Multi-Ethnic Study of Atherosclerosis phosphate homeostasis Source Type: blogs
FDA Should Pass The Salt…Standards
Editor's note: In addition to Rep. Rosa DeLauro, Sen. Tom Harkin also coauthored this post.
For years, Americans have been inundated with messages about the dangers posed by the food we eat whether from fat, carbohydrates, or sugar. But another additive lurks in virtually every package and bag on the supermarket shelves, as well as practically every restaurant meal, and it is having a dire impact on our health.
That additive is sodium, and Americans are consuming far too much, with profoundly negative consequences on our health and well-being as a country. It is time for the U.S. Food and Drug Administration (FDA) to t...
Source: Health Affairs Blog - June 16, 2014 Category: Health Management Authors: Rep. Rosa DeLauro Tags: All Categories Health Care Costs Health Reform Policy Prevention Public Health Source Type: blogs
Upstream Problems
He had been through this before. The patient, a 57-year-old man, had come through the doors of this emergency department many times. He had a favorite seat in triage. He knew what questions the nurse would ask him once he was in a room, and that the doctor would repeat those same questions. Then tests and labs, then moved upstairs for a couple of days before going home, hopefully feeling better. He knew all of this. Today, though, everything he thought he knew was wrong.
He had once considered himself lucky. He even survived a gunshot to the chest as a young man. But that notion had faded long ago. His health had been gett...
Source: Spontaneous Circulation - May 12, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Upstream Problems
He had been through this before. The patient, a 57-year-old man, had come through the doors of this emergency department many times. He had a favorite seat in triage. He knew what questions the nurse would ask him once he was in a room, and that the doctor would repeat those same questions. Then tests and labs, then moved upstairs for a couple of days before going home, hopefully feeling better. He knew all of this. Today, though, everything he thought he knew was wrong.
He had once considered himself lucky. He even survived a gunshot to the chest as a young man. But that notion had faded long ago. His health had been get...
Source: Spontaneous Circulation - May 12, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
New Publication: Chronic Kidney Disease in an Electronic Health Record Problem List
Full title is, “Chronic Kidney Disease in an Electronic Health Record Problem List: Quality of Care, ESRD, and Mortality” published in the American Journal of Nephrology. It has implications for CKD but other chronic conditions as well regarding the appropriate use of problem lists in the EMR. With CKD, diabetes and other chronic conditions which can be initially diagnosed with a lab test (eGFR for CKD), early identification is possible. But if the patient is not formally given the diagnosis in the problem list, it may lead the lack of early preventive care which can slow the progression of a chronic illness....
Source: eHealth - April 2, 2014 Category: Technology Consultants Authors: John Sharp Tags: Uncategorized CKD EHR EMR Medical Informatics Source Type: blogs
Those amazing little kidneys
Years ago I was a dialysis nurse and I could not believe what I learned about these little organs in your body and how they actually work. First let’s note that these are bean-shaped and about the size of a fist. The kidneys are located near the middle of the back, on each side of the spine. Kidneys, if healthy, are working 24 hours a day, 7 days a week; they are like a built-in water treatment plant! Their main job is to filter the blood – to maintain a balance of water and chemicals. Every day these amazing little organs filter out about 2 quarts of wastes and fluid in the form of urine.
Unfortunatel...
Source: Nursing Comments - March 13, 2014 Category: Nurses Authors: Stephanie Jewett, RN Tags: Advice/Education General Public Home/Articles Nursing/Nursing Students Patients/Specific Diseases acute blood loss AKI ARF chronic kidney disease diabetes dialysis end-stage renal disease high blood pressure Kidneys poison Source Type: blogs
Warfarin Benefits Extended To Patients with Chronic Kidney Disease
Anticoagulation is a cornerstone of therapy for atrial fibrillation because it lowers the heightened risk for stroke in this population. People with chronic kidney disease are also at increased risk for stroke, but the benefits of anticoagulation are less clear in this group, and anticoagulation is used less often in AF patients who have CKD. Now, a large observational study offers some reassurance that anticoagulation in AF patients with CKD may be beneficial. Researchers in Sweden analyzed data from more than 24,000 survivors of acute myocardial infarction who had AF…. … Click here to read More… (Source: CardioBrief)
Source: CardioBrief - March 4, 2014 Category: Cardiology Authors: Larry Husten Tags: Heart Rhythms Prevention, Epidemiology & Outcomes AF anticoagulation atrial fibrillation chronic kidney disease stroke prevention warfarin Source Type: blogs
High risk patient characteristics for potential stent thrombosis
while interrupting anti-platelet agents for surgery are: Recent acute coronary syndrome, history of stent thrombosis, low left ventricular ejection fraction, chronic kidney disease and diabetes mellitus. (Source: Cardiophile MD)
Source: Cardiophile MD - February 22, 2014 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
