Research and Reviews in the Fastlane 050
This study compared bedside US by EPs vs radiology US vs CT as the INITIAL test in patients expected with nephrolithiasis. It found there was no difference in serious outcomes between the groups, but the rate of serious outcomes was overall very low.
Obviously patients that got only an US had lower radiation exposure and lengths of stay. But what is interesting is that 40% of patients with an initial ED US went on to get a CT also.
This study does not state that patients should ONLY undergo US, just that it should be the INITIAL test. If it cuts down on our CT ordering, it sounds like a good start. (Zack Repanshek)
Recomme...
Source: Life in the Fast Lane - September 29, 2014 Category: Emergency Medicine Authors: Jeremy Fried Tags: Cardiology Clinical Research Emergency Medicine Infectious Disease R&R in the FASTLANE Radiology Resuscitation critical care Education Intensive Care literature recommendations Research and Review Source Type: blogs
What Happens When Patients Won't Take Meds?
You're here reading Shrink Rap, so you may think this is a post about patients who refuse to take psychiatric medications, and non-compliance with psychiatric medications gets to be it's own issue. So it caught my attention when Dr. Albert Fuchs tweeted that he was interviewed by NPR about "What happens when patients won't take medicines." Dr. Fuchs is a primary care doc with a concierge practice in Beverly Hills, so I wanted to hear what he had to say, and I invested 6 minutes of my life in listening to his NPR talk -- you may want to go to the website and listen as well. He makes a good point about bein...
Source: Shrink Rap - August 18, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Beer and Health: Nine Questions Answered
By Amy Campbell
In honor of International Beer Day, an unofficial holiday that was observed on August 1, I thought I'd take the opportunity this week to focus on this well-loved beverage.
Beer has been around for a long time. Evidence of beer dates back about 5,000 years (those ancient Sumerians surely knew how to have a good time). Archeologists have unearthed vessels from about 3,400 BC lined with beer residue. And the ancient Egyptians enjoyed beer as part of their daily lives — even children drank this bubbly brew.
What is beer?
According to the website A Perfect Pint, beer is an alcoholic beverage usually made f...
Source: Diabetes Self-Management - August 4, 2014 Category: Diabetes Authors: Amy Campbell Source Type: blogs
Personae Public and Private
The house is done; we’re all moved in, mostly unpacked, and just starting to get organized. The guest room is my temporary writing room. No more excuses. Back to blogging.
My post analogizing car seats to vaccines has taken on second life thanks to a cool Australian site (Thanks, Mamamia of Oz.) This in turn has generated more comments (thanks, all!) including a long, thoughtful one from Patrick, who begins thusly:
I honestly believe there is fault on both sides of this debate. Vilifying and ridiculing each other doesn’t bring about good health results.
I feel the need to clarify something here:
I am not the same i...
Source: Musings of a Dinosaur - July 22, 2014 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Creating a Signature Life From a Really Bad Day
Monday was a really bad day. It started at 11pm, the previous night (Sunday). I woke up with a huge pain in my side, the classic case of a kidney stone. I tried to go back to sleep, hoping that I would discover that it was just a dream. It wasn’t. After a fitful few tries, I got up and walked around. I have had a number of kidney stones in my life, and they usually measure way up on the pain charts. This one was a 6 or 7 out of ten. Tolerable.
The problem was, I was over 200 miles from home in Bakersfield California, spending the night in a hotel for a two day training gig at the start of the week. Why do things lik...
Source: Success Begins Today - July 16, 2014 Category: Life Coaches Authors: John W Richardson Tags: blog Career signature life Source Type: blogs
Is it a Kidney Stone?
(Source: EverythingHealth)
Source: EverythingHealth - July 9, 2014 Category: Consumer Health News Source Type: blogs
On Call
Every ER has its call roster, that sacred list of oracles, laying out who we can call when our patients need some service that we cannot provide. If I need a cardiologist, or a neurosurgeon or even a dermatologist for some acute emergency condition, all I need to do is ring up the operator and tell them, “This is the ER doc, I need [insert name of specialty here].” And like magic, ten minutes later, I’m talking to the local expert in whatever the patient has.Fun fact: in the last month, I have consulted both physiatry and rheumatology from the ER.So I was a little surprised recently when I had a patient with a nine-m...
Source: Movin' Meat - July 7, 2014 Category: Emergency Medicine Source Type: blogs
Conflicting state versus federal incentives confuse doctors
I get paid by Medicaid to see patients. How much?
Exactly $52.28 if it is an easy patient issue, like a cold, and $78.54 for a harder one, like a kidney stone. Who decides when the issue is easy and when it is hard? I do. But I have to follow some complex rules when deciding whether to bill a 99213 (a level 3, or easier visit) vs a 99214 (a level 4, or harder visit). If I can bill a level 4 instead of a level 3, I get paid $26.26 (about 50%) more, so it is in my interest to turn simple problems into harder ones.
Continue reading ...
Your patients are rating you online: How to respond. Manage your online reputation: A soci...
Source: Kevin, M.D. - Medical Weblog - July 4, 2014 Category: Journals (General) Authors: P.J. Parmar, MD Tags: Policy Emergency Medicare Source Type: blogs
The high cost of kidney stones
I wish I could share the photo of my 4mm boomerang shaped kidney stone. I labored for 2 months, back in early 2009 to pass it, the second stone in 5 years.
During my ordeal with these stones, I had the following health care encounters, tests, medicines, lab and imaging tests.
at least 5 sets of blood work, with CBC and chemical profiles, parathyroid studies
several urine tests, including urinalysis and urine culture, and 2 24 hour urine tests (a third 24 hour urine test was recommended but I declined)
2 CT scans
1 MRI
4 specialist visits, 2 primary care visits, 2 ER visits (involving IVs, pain meds, lab studies)
prescri...
Source: Kevin, M.D. - Medical Weblog - May 29, 2014 Category: Journals (General) Authors: Kathy Day Tags: Patient Emergency Nephrology Source Type: blogs
Pain management and a chemical menopause
Current CA125 level: 11Current pain level: highMood: weary and uncertainThings have been on a bit of a roller coaster since I last wrote. Everything had been starting to get better since the hysterectomy last July and I was starting to feel physically stronger. Then a few months ago the pain came back and it's been getting worse ever since.I've always had some residual abdominal pain since the hysterectomy but day-to-day things had started to become a bit easier, like walking Molly to school and carrying Tess around. I got to Christmas feeling positive about the future and hopeful that hospital admissions were fina...
Source: Diary of a Cancer Patient - April 1, 2014 Category: Cancer Source Type: blogs
Produce of the Day: Citrus
All this month I’m making it fun to eat better with my 30-Day Challenge “Half Plate Produce” in the spirit of National Nutrition Month’s theme “Enjoy the taste of eating right!”
Tweet, Post, Instagram or Pin your favorite pics and recipes that help make it fun for YOU to eat better. (Use #30DayChallenge and #NNM in your messages.)
Feature Produce of the Day: Citrus
Nothing brightens up a dreary March day like a pop of vibrant citrus – its bright color and fresh flavor help remedy most cases of late-winter funk. One bite of a juicy tangerine immediately gets me dreaming of sunshine a...
Source: Balanced Health and Nutrition Rebecca Scritchfield's Blog - March 19, 2014 Category: Nutritionists and Food Scientists Authors: rebeccascritchfield Tags: cooking eating healthy food fruits nutrition recipes 30 day challenge citrus sunkist Source Type: blogs
Anabolic Steroids like Trenbolone
In the last few decades, the focus of a big majority of athletes has shifted towards performance enhancing drugs such as anabolic steroids. The fact that these bodybuilding steroids or anabolic androgenic steroids can dramatically improve the level of on-field performance, strength, muscle mass, and endurance means that there is every reason that athletes admire these drugs.
Different athletes make use of different anabolic steroids for a wide range of purposes. While some use steroids to run faster and become more agile than ever, some use these potent drugs to hit harder and stay ahead of the competition, while others us...
Source: Mental Nurse - December 20, 2013 Category: Nurses Authors: Iqcguest Tags: Health anabolic steroids performance enhancing drugs Source Type: blogs
Become a Mountain
When I was 16 years old I wrote a short collection of poems. The cover page listed a few youthful notions that would become my life long guiding principles:"Be wary of artificial limits and self-compromiseIf the world praises mediocrity, don't seek praiseBe true to yourselfYou make your own destiny"Some of these ideas were written in response to high school teachers who told me that my goals were unachievable - I should not ask "will I" but "can I".Over my career, I've worked with and for many people. Along the way I've encountered many styles - those who lead by intimidation, those who lead by collaboration,...
Source: Life as a Healthcare CIO - December 18, 2013 Category: Technology Consultants Source Type: blogs
Philips Introduces IQon, World’s First Spectral Detector CT
At RSNA, Philips is introducing its IQon Spectral CT system, the world’s first spectral-detector CT scanner. Spectral CT provides information about tissue composition by determining energy levels of detected X-ray photons. The information provided is similar to that obtained by dual-energy CT, but without some of the typical trade-offs associated with that technique.
At the core of the IQon Spectral CT lies a fundamentally new spectral detector, that can discriminate between X-ray photons of multiple high and low energies simultaneously. Philips likens this to using a prism to split a beam of white light into its com...
Source: Medgadget - December 5, 2013 Category: Technology Consultants Authors: Wouter Stomp Tags: Cardiology Radiology Urology Vascular Surgery Source Type: blogs
Products Of kidney stones – Where To Go
Then right here are some guidelines that might just support you out. One of the best ways to take care of this vital organ is through the help of herbal remedies. Pitta type- Diuretics, which are cooling type like burdock, dandelion, and horsetail are indicated in dose of 1 to 3 gms, a day for [...] (Source: Carin' For Karen)
Source: Carin' For Karen - November 30, 2013 Category: Cancer Authors: Nilda54Hvax Tags: Life in general Source Type: blogs
