Failure To Communicate: The Dangers Of Inadequate Hospital Handoffs And What To Do About It
One of my biggest pet peeves is taking over the care of a floor-full of complicated patients without any explanation of their current conditions or plan of care from the physician who most recently treated them. Absent or inadequate verbal and written “handoffs” of patient care are alarmingly common in my experience. I work primarily as a locum tenens physician, traveling across the country to “cover” for my peers on vacation or when hospitals are having a hard time recruiting a full-time MD. This type of work is particularly vulnerable to gaps in continuity of care, and has heightened my awareness ...
Source: Better Health - March 24, 2014 Category: Health Medicine and Bioethics Commentators Authors: Dr. Val Jones Tags: Health Policy Health Tips Opinion Change Of Shift Communication Failure To Communicate hand off History And Physical Exam Hospital Sign-Outs Hospitalists Locum Tenens Medical Errors Nursing Progress Note Sign out Talk Source Type: blogs
Suggesting the Use of Osteoclasts to Revert Heart Calcification
The whole cardiovascular system becomes increasingly calcified with advancing age. As is also the case for the accumulation of advanced glycation endproducts (AGEs) this process increases vascular stiffness and otherwise degrades the functionality of heart and blood vessel tissues. A few researchers have proposed a similar strategy to that adopted for AGEs, which is to find drugs to remove the calcification. Here, however, an alternative approach is suggested:
Cardiovascular calcification (deposits of minerals in heart valves and blood vessels) is a primary contributor to heart disease, the leading cause of death among bo...
Source: Fight Aging! - March 14, 2014 Category: Health Medicine and Bioethics Commentators Authors: Reason Tags: Daily News Source Type: blogs
Patients who have dental extractions before cardiac surgery are still at risk for poor outcomes
To pull or not to pull? That is a common question when patients have the potentially dangerous combination of abscessed or infected teeth and the need for heart surgery. In such cases, problem teeth often are removed before surgery, to reduce the risk of infections including endocarditis, an infection of the inner lining of the heart that can prove deadly. But Mayo Clinic research suggests it may not be as simple as pulling teeth: The study found that roughly 1 in 10 heart surgery patients who had troublesome teeth extracted before surgery died or had adverse outcomes such as a stroke or kidney failure. The findin...
Source: Dental Technology Blog - March 13, 2014 Category: Dentists Source Type: blogs
ICD and Pacemaker deactivation: It is neither physician-assisted suicide nor euthanasia
The purpose of this post is to clarify important issues about cardiac devices as they relate to deactivation. As I wrote yesterday, Paula Span of the NY Times covered this important issue earlier this week. Her coverage came about because of this Mayo Clinic paper published in JAMA-IM, which showed most patients with cardiac devices approach end of life without proper preparation.
The first two questions to clarify are: What is a cardiac device and what does it mean to deactivate it? When we say “cardiac device” we are referring to either an Internal Cardiac Defibrillator (ICD) or a pacemaker. There are many im...
Source: Dr John M - January 31, 2014 Category: Cardiology Authors: Dr John Source Type: blogs
Boehringer's "gross inadequacy"
Boehringer Fined $931,000 Over Lost Pradaxa FilesBoehringer Ingelheim GmbH, which markets and manufactures Pradaxa, has been charged with a nearly $1 million fine, according to a recent ruling. The fine was levied for the drug maker’s withholding or failing to preserve files sought in Pradaxa litigation, according to the judge’s ruling.The “countless” files were sought by patients who have brought lawsuits over the blood thinner, Pradaxa, Bloomberg News reports. U.S. District Judge David Herndon, located in East St. Louis, Illinois, is overseeing more than 1,700 consolidated lawsuits that have been f...
Source: PharmaGossip - December 13, 2013 Category: Pharma Commentators Authors: insider Source Type: blogs
Mitral Regurgitation
Mitral regurgitation - a "leaky" mitral valve - is the most common of the heart valve abnormalities, and can be one of the most difficult to evaluate and treat. It can lead to severe symptoms, heart failure, and heart arrhythmias. The appropriate treatment of mitral regurgitation requires careful and regular medical evaluations - and it requires you to pay attention to how you're feeling....Read Full Post (Source: About.com Heart Disease)
Source: About.com Heart Disease - December 13, 2013 Category: Cardiology Source Type: blogs
Infectious Endocarditis
Infectious endocarditis - which sometimes is also called subacute bacterial endocarditis (SBE), or just "endocarditis" - is an infection of the endocardial surface (the interior lining) of the heart. Infectious endocarditis is always a serious medical problem, since the infection can destroy your heart valves or heart muscle....Read Full Post (Source: About.com Heart Disease)
Source: About.com Heart Disease - December 9, 2013 Category: Cardiology Source Type: blogs
The antibiotics crisis
Why are antibiotics so important?Without them, modern medicine would not be possible. Arguably the most important factor in the 30-year jump in American life expectancy in the 20th century, these "wonder drugs" allow us to fight the whole gamut of bacterial illness, from everyday ear infections to diseases such as syphilis, typhoid, and tuberculosis that used to kill millions of people. Their discovery about 100 years ago also revolutionized the world of surgery: As antibiotics drastically reduced the number of post-operative infections, standard operations that used to be considered perilous — such as appendix removals ...
Source: PharmaGossip - November 18, 2013 Category: Pharma Commentators Authors: insider Source Type: blogs
Most common combination lesion in RHD
Most common combination lesion in rheumatic heart disease (RHD):
a) Mitral stenosis + Tricuspid stenosis
b) Aortic stenosis + Tricuspid stenosis
c) Mitral regurgitation + Aortic regurgitation
d) Mitral regurgitation + Pulmonary regurgitation
Correct answer: c) Mitral regurgitation + Aortic regurgitation
Most common lesion in acute rheumatic fever is mitral regurgitation. The frequency of involvement in rheumatic heart disease depends on the hemodynamic load. Mitral valve faces the most load due to the LV systolic pressure, next comes aortic valve with aortic diastolic pressure. Least is for pulmonary valve with pulmonary ...
Source: Cardiophile MD - October 31, 2013 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance hemodynamic load on heart valves RHD rheumatic heart disease Source Type: blogs
Not all sore throats are self-limited – the role of antibiotics
This article is written in French, but the translate button allowed me to read the article clearly.
These ENTs note increasing numbers of peritonsillar abscess. They argue that sore patients deserve more than a rapid test. They argue for a history and physical done by a physician who looks for complications and explains red flags to the patient.
Long time readers know that I lament the term “just a sore throat”. While most sore throats are self-limited, we still should respect the possibilities for either suppurative or non-suppurative complications. I argue regularly that our sore throat treatment nihilism...
Source: DB's Medical Rants - October 22, 2013 Category: Health Medicine and Bioethics Commentators Authors: rcentor Tags: Medical Rants Source Type: blogs
The Significant Physician Contribution to the Development of Medical Devices
Discussion
The results of this study show that the relationship between large medical device companies and startups impacts patenting and product market innovation. The actual impact of legislation such as the Sunshine Act might transmit through multiple channels.
First, the results show "that direct investment by the incumbent [manufacturer] in a startup is associated with greater use of the startup's patents (although not with a greater maximum information overlap between the startup's patents and the investor's PMAs). This suggests that curtailing investment activity in physician-founded startups might restrict ...
Source: Policy and Medicine - October 10, 2013 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs
FDA Expands Access to Edwards Lifesciences’ Sapien Heart Valves
About 300,000 patients nationally suffer from degradation of the aortic heart valve, which forces the heart to work harder to pump blood, often leading to heart failure, blood clots and sudden death. While open aortic valve replacement for stenosis is the standard of care, about 30% of patients face contraindications to open surgery, which is obviously very invasive.
As a means of addressing the needs of this population, the Food and Drug Administration this week approved revised labeling for Edwards Lifesciences‘ (Irvine, CA) SAPIEN transcatheter heart valve, which is approved for patients who face major risks from...
Source: Medgadget - September 26, 2013 Category: Technology Consultants Authors: Ravi Parikh Tags: Cardiac Surgery Cardiology Source Type: blogs
Apica Access, Stabilization, and Closure Device for Beating Heart Valve Replacement (VIDEO)
Apica Cardiovascular, a company based in Galway, Ireland, has developed an innovative platform that will help change the game for valve implant procedures requiring transapical access, such as TAVI (transcatheter aortic valve implantation). Using the apex of the heart as the entry point, the Access, Stabilization, and Closure (ASC) system allows surgeons to implant prosthetic aortic and mitral valves, all while the heart continues to beat. Upon a successful implantation, the system standardizes closure by quickly stabilizing and sealing the tissue of the access point without conventional sutures, minimizing blood loss and ...
Source: Medgadget - September 25, 2013 Category: Technology Consultants Authors: Nishey Wanchoo Tags: Cardiac Surgery Cardiology Source Type: blogs
Using Registry Data, FDA Expands Indication For Edwards’ Sapien Transcatheter Heart Valves
Relying on an important new source of information. the FDA said today that it had expanded the label for the Sapien Transcatheter Heart Valve (Edwards Lifesciences). Previously the Sapien was approved for insertion via the transfemoral or transapical access points in patients not eligible for traditional aortic valve surgery. The new labeling no longer mentions access points and therefore allows for alternative access points such as the subclavian. The most significant part of the FDA’s announcement may be not the label change itself but the source of the data supporting the claim, the Transcatheter Valve Therapy R...
Source: CardioBrief - September 23, 2013 Category: Cardiology Authors: Larry Husten Tags: Interventional Cardiology & Surgery People, Places & Events Policy & Ethics Source Type: blogs
TriGuard for Prevention of Strokes During Transcatheter Aortic Valve Replacements Cleared in Europe (VIDEO)
Keystone Heart, a company based in Caeserea, Israel, won the European CE Mark of approval to bring to market its TriGuard Cerebral Protection Device, a filter designed to prevent the entry of emboli into the vasculature leading up to the brain when performing transcatheter aortic valve replacement (TAVR) procedures.
Strokes are a serious cause for concern when placing prosthetic heart valves through minimally invasive techniques because a good deal of calcified material stuck to the walls around the native valve can get dislodged. The TriGuard device is delivered via the same access ports as the instruments used for TAVR...
Source: Medgadget - September 17, 2013 Category: Technology Consultants Authors: Editors Tags: Cardiac Surgery Cardiology Radiology Source Type: blogs
