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Urgent Care Follies
What is it with antibiotics and steroids for upper respiratory infections at Urgent Care these days? Over-prescribing of antibiotics has been a problem ever since the recognition that uncomplicated upper respiratory infections were almost always viral and would resolve on their own. I like to call the Z-pak (a pre-packaged 5-day course of azithromycin, a macrolide antibiotic) a “Placebo Antibiotic.” It doesn’t help a viral infection, but has relatively few side effects, and the accomplishment of making the patient feel like he’s gotten something for his handsome $15.00 co-pay. Not optimal treatment ...
Source: Musings of a Dinosaur - May 26, 2017 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs

Rating Portable Diagnostic Devices That Make Patients the Point-of-Care
Although the medical tricorder will remain a dream to be chased by digital health innovators for the years to come, I collected the portable, digital health diagnostic devices currently on the market in case anyone is thinking about purchasing an effective gadget making the patient the point of care. Chasing the dream of the medical tricorder Dr. McCoy’s medical tricorder from the Star Trek series, which could scan a patient and immediately tell the diagnosis, basic vital signs and health parameters is the dream of many doctors. In 2012, Qualcomm announced the Tricorder XPRIZE competition offering millions of dollars...
Source: The Medical Futurist - May 23, 2017 Category: Information Technology Authors: nora Tags: Future of Medicine Mobile Health Portable Diagnostics blood pressure digital health GC1 Healthcare heart rate Innovation Personalized medicine technology trackers wearables Source Type: blogs

Nitrite Sensor to Help Asthmatics Detect Onset of Airway Inflammation
The presence of relatively high concentrations of nitrite (NO2−) in exhaled breath may be indicative of the presence of inflammatory processes within the airways, and so measuring it may be an effective way of performing early detection of the onset of the symptoms of asthma and other respiratory conditions. Devices that are able to measure nitrite are bulky and impractical for everyday use, but Rutgers University scientists have now developed a graphene-based sensor for measuring the concentration of nitrite in exhaled breath that they believe will result in a new approach to monitoring and managing asthma and ...
Source: Medgadget - May 22, 2017 Category: Medical Devices Authors: Editors Tags: Diagnostics Medicine Pediatrics Source Type: blogs

Fight Aging! Newsletter, May 22nd 2017
In this study, researchers analysed data of millions of British patients between 1995 and 2015 to see if this claim held true. They tracked people who were obese at the start of the study, defined as people with a body mass index (BMI) of 30 or more, who had no evidence of heart disease, high blood pressure, high cholesterol or diabetes at this point. They found these people who were obese but "metabolically healthy" were at higher risk of developing heart disease, strokes and heart failure than people of normal weight. No such thing as 'fat but fit', major study finds Several studies in the pas...
Source: Fight Aging! - May 21, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

Non-Contact Respiratory Rate Sensor Built Into a Cotton T-Shirt
At the Université Laval in Quebec City, Canada, researchers have developed a respiration sensor built into a t-shirt that can be sampled by a nearby radio device. The idea is that patients in a hospital would wear a lightweight, comfortable shirt that doesn’t have any wires, while their breathing rate would be discreetly monitored in real-time. The sensor itself is simply a spiral antenna made out of multi-material fibers. It’s embedded into the fabric of a common cotton t-shirt so that the expansion of the chest on every breath causes the antenna to bend slightly. This change in the geometry o...
Source: Medgadget - May 19, 2017 Category: Medical Devices Authors: Editors Tags: Anesthesiology Critical Care Diagnostics Medicine Pediatrics Surgery Source Type: blogs

Suggesting Mitochondrial Dysfunction Contributes to Age-Related Hair Loss
Researchers here investigate declining mitochondrial function in the context of hair growth, suggesting that age-related mitochondrial dysfunction is one of the causes of loss of hair in later life. Lower levels of - and less efficient - mitochondrial activity is implicated in a number of age-related diseases, especially those of the brain, where correct function requires large amounts of the energy store molecules produced by mitochondria. There appear to be several processes at work, ranging from mitochondrial DNA damage thought important in the SENS view of aging to a general and broader mitochondrial malaise that might...
Source: Fight Aging! - May 18, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Researchers Generate Improved Lung Tissue Organoids
In tissue engineering this is the age of organoids: while the challenge of generating a blood vessel network sufficient to grow large tissue sections is not yet solved, researchers are nonetheless establishing the diverse set of methodologies needed to grow functional organ tissue from a cell sample. The recipe is different for every tissue type, and there are many forms of tissue in the body. The resulting small tissue sections are known as organoids. At this time organoids are largely used to speed up further research, but for some tissue types there is the potential to produce therapies based on transplantation of multi...
Source: Fight Aging! - May 16, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Do not consume the flesh of tetrapods
Well, maybe birds are okay, it isn't entirely clear. The horrific harm to the planet from human meat consumption doesn't seem to be motivating very many people to stop it,but maybe the risk of death will.With a total of more than 7.5 million person years of observation, further analyses by Etemadi and colleagues (doi:10.1136/bmj.j1957) now show an association between high intakes of red and processed meat and elevated total mortality and mortality from most major causes: cardiovascular disease, diabetes, cancer, and hepatic, renal, and respiratory diseases.As the BMJ editorialist goes on to remind you of what you already k...
Source: Stayin' Alive - May 15, 2017 Category: American Health Source Type: blogs

Repetition and the basics – #meded
Discussing a new patient recently, two important teaching points crystallized once again.  The patient was relatively young without any past medical problems.  He had dyspnea, first on exertion, and then at rest.  On exam he was tachypneic with crackles, wheezes and rales throughout his lungs.  After receiving nasal oxygen he “looked comfortable”. His electrolyte panel: 135 90 8 103 4.8 30 0.6 So I asked why his bicarbonate was 30. A fairly long discussion ensued.  The major point of the discussion was that an elevated bicarbonate here might be a danger sign.  I belie...
Source: DB's Medical Rants - May 14, 2017 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Research and Reviews in the Fastlane 181
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the  181st edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains  5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Justin Morgenst...
Source: Life in the Fast Lane - May 11, 2017 Category: Emergency Medicine Authors: Jeremy Fried Tags: Emergency Medicine Intensive Care R&R in the FASTLANE Toxicology and Toxinology critical care EBM literature recommendations research and reviews Resuscitation Source Type: blogs

Research and Reviews in the Fastlane 181
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the  181st edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains  5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Jus...
Source: Life in the Fast Lane - May 11, 2017 Category: Emergency Medicine Authors: Jeremy Fried Tags: Emergency Medicine Intensive Care R&R in the FASTLANE Toxicology and Toxinology critical care EBM literature recommendations research and reviews Resuscitation Source Type: blogs

Electronic Medical Records 2017: Science Ignored, Opportunity Lost
By KENNETH BARTHOLOMEW, MD My big brother Bill, may he rest in peace, taught me a valuable lesson four decades ago. We were gearing up for an extended Alaskan wilderness trip and were having trouble with a piece of equipment. When we finally rigged up a solution, I said “that was harder than it should have been” and he quipped in his wry monotone delivery, “There are no hard jobs, only the wrong tools.” That lesson has stuck in my mind all these years because, as simple as it seems, it carries a large truth. It rings of Archimedes when he was speaking about the simple tool known as the lever: &ldquo...
Source: The Health Care Blog - May 8, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized EHR EMR Knowledge Coupler Number Needed to Kill POMR value-based care Source Type: blogs

Even short term use of oral steroids (less than 30 days) linked to increased risk of severe infection (sepsis), blood clots and fracture
One in five American adults in a commercially insured plan were given prescriptions for short term use of oral corticosteroids during a three year period, with an associated increased risk of adverse events. Of 1.5 million adults, 21% received at least 1 prescription for oral corticosteroids over 3 period.The most commonindications for use were:- upper respiratory tract infections- spinal conditions- allergies.Within 30 days of drug initiation, there wasan increase in rates of:- sepsis- venous thromboembolism- fractureRisk over the subsequent 31 –90 days.The increased risk persisted at prednisone equivalent doses of ...
Source: Clinical Cases and Images - Blog - May 8, 2017 Category: Universities & Medical Training Tags: Allergy Infectious Diseases Pulmonology Source Type: blogs

Transitioning from Hospital to Nursing Home Most Practical Move for Some
Dear Carol: My 83-year-old mother has lived with my family for two years, but her Type 1 diabetes and lung problems have been worsening. She also has severe pain from arthritis. Mom was recently hospitalized with a respiratory infection and took a long time to respond to treatment. They finally got the bacteria under control but she’s very weak and her breathing needs monitoring. The doctor insisted that she should only be released to a nursing home. I asked if this was just a time for recovery but he was strong in recommending that she move there permanently. He said that she needs more nursing care than she ca...
Source: Minding Our Elders - May 7, 2017 Category: Geriatrics Authors: Carol Bradley Bursack Source Type: blogs

Oxidative Stress Caused by Immune Cells Contributes to the Age-Related Decline in Liver Regenerative Capacity
Researchers here provide evidence for the age-related decline in regenerative capacity of the liver to be caused in part by oxidative stress produced by innate immune cells. This makes the adult stem cells responsible for tissue maintenance less likely to activate, but when removed from the tissue environment the cells appear more or less as capable as those of younger individuals. In some other tissues, such as muscle, where stem cell biology is better studied, it is also thought that changes in the surrounding environment rather than internal damage drives the majority of the decline in stem cell activity with aging. Thi...
Source: Fight Aging! - May 5, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Introducing Loop Vital Signs Wearable Monitor from SpryHealth
SpryHealth, previously Echo Labs, is announcing the launch of Loop, a clinical-grade wearable designed to enable improved health outcomes through continuous vital sign monitoring and early detection of clinical deterioration. SpryHealth was founded by Pierre-Jean “PJ” Cobut and Elad Ferber out of the Stanford Graduate School of Business and StartX, a Stanford accelerator. They started the company to enable proactive care and reduce the nearly 28M hospital admissions attributed to chronic conditions. Little is known for now on the technology behind Loop, however, SpryHealth indicates&nbs...
Source: Medgadget - May 4, 2017 Category: Medical Equipment Authors: William Kethman Tags: Diagnostics Telemedicine Source Type: blogs

Mitochondria-Derived Damage-Associated Molecular Patterns in Aging
Mitochondria-derived damage-associated molecular patterns (DAMPs) are a proposed link between age-related mitochondrial damage and age-related inflammation, and this open access paper outlines present thinking on the topic. Mitochondria, the power plants of the cell, are strongly implicated in the progression of aging in a number of ways, the SENS view of damage to mitochondrial DNA producing dysfunctional cells being one, and a more general decline in mitochondrial energy generation for other reasons, yet to be fully mapped, being another. DAMPs are more in line with the first view rather than the second, in which broken ...
Source: Fight Aging! - May 4, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

S+, Setting a New Standard in Consumer and Clinical Sleep Technology: Interview with Colin Lawlor, CEO of SleepScore Labs
Launched a little under four months ago, the S+ platform is the newest technology disrupting the $60B consumer sleep industry. Developed by SleepScore Labs, a joint venture between ResMed, a 25-year leader in prescription sleep medical devices, Dr. Mehmet Oz, and Pegasus Capital Advisors, the S+ is a clinical grade, non-prescription, non-contact sleep monitoring device coupled with a mobile app. Involving over 10 years of development, SleepScore’s technology is the first step towards the company’s vision of revolutionizing the world of sleep science by setting a new standard for both clinical and consumer monit...
Source: Medgadget - May 3, 2017 Category: Medical Equipment Authors: Michael Batista Tags: Exclusive Telemedicine Source Type: blogs

My first mistake could have been fatal
Recently, our three-year-old wandered into our bedroom around 4 a.m. waking me up, saying he was scared. As I did the previous few nights when he did this, I muttered a curse word to myself and picked him up to carry him back to his room. Upon lifting him, a wrinkle in the routine emerged — he was naked below the waist. At some point, before he entered our room, his pajama pants and pull-up were removed. A mystery had arisen. Yes, the game was afoot. *** Rewind 10 years. I am three months into intern year as a pediatric resident. I am taking call every fourth night on the inpatient pediatric hematology/oncology ward,...
Source: Kevin, M.D. - Medical Weblog - May 2, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/rogue-dad" rel="tag" > Rogue Dad, MD < /a > Tags: Physician Primary care Source Type: blogs

Patient-dictated vs. patient-centered care. What can physicians do?
Patient-centered care (PCC) seems to be a popular buzzword among policymakers and administrators in recent years. Indeed, many physicians see our health care system as payer-centric, many patients see it as physician-centric, and no one seems to see it as patient-centric. While putting the patient at the center of what we do as physicians is critical to improving the triple aim of better care, better health, and lower costs, it is important to keep in mind what this exactly means; PCC is not the same as patient-dictated care (PDC). We have all experienced patients who demand certain tests or treatments and see the physicia...
Source: Kevin, M.D. - Medical Weblog - May 2, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/kyle-bradford-jones" rel="tag" > Kyle Bradford Jones, MD < /a > Tags: Physician Primary care Source Type: blogs

Frankly my dear, I do give a damn
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka: Paediatric Perplexity 016 An 18 month old girl is brought in by Gran after developing a very red rash over the last 2 days. She was seen by her GP a few days before with fevers, sore throat and lethargy and was diagnosed as a viral infection. However the rash then came up the following day and she seemed to deteriorate… What is the diagnosis? + Reveal Answer expand(document.getElementById('ddet656783326'));expand(document.getElementById('ddetlink656783326')) S...
Source: Life in the Fast Lane - May 2, 2017 Category: Emergency Medicine Authors: Johnny Iliff Tags: Clinical Cases Pediatrics paediatric rash scarlet Source Type: blogs

Death by Poison
​Poison has been used for many purposes since humans have existed, often for assassination or assassination attempts. Some of those make the news, the most recent being the assassination of Kim Jong-nam, the half-brother of North Korean leader Kim Jong-un.Authorities identified the nerve agent VX on his face, and video corroborated two women wiping a substance on his face before his collapse and death. VX is the most potent nerve agent, and was developed in the United States in the 1950s during the Cold War. It is an acetylcholinesterase inhibitor, and exerts its effects like organophosphate insecticides. Victims develop...
Source: The Tox Cave - May 1, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Keep your seasonal allergies in check
Seasonal allergies can be frustrating. When spring crawls in, many people begin to experience all-too-familiar itchy and watery eyes, runny nose, and congestion. Symptoms of seasonal allergies are the result of an immune system in overdrive in response to pollen and other allergens. Those bothersome symptoms are intended to protect you from unwanted foreign particles, but in this situation they end up causing misery. There are quite a few options when it comes to controlling allergy symptoms, but we want to watch out for a few that can be quite dangerous when used incorrectly. Nasal steroids The first-line treatment for se...
Source: Harvard Health Blog - May 1, 2017 Category: Consumer Health News Authors: Dominic Wu, MD Tags: Asthma and Allergies Ear, nose, and throat Health Source Type: blogs

Fight Aging! Newsletter, May 1st 2017
In this study we demonstrate the use of clustered regularly interspaced short palindromic repeats (CRISPR)-based epigenome editing to alter cell response to inflammatory environments by repressing inflammatory cytokine cell receptors, specifically TNFR1 and IL1R1. This has applications for many inflammatory-driven diseases. It could be applied for arthritis or to therapeutic cells that are being delivered to inflammatory environments that need to be protected from inflammation." In chronic back pain, for example, slipped or herniated discs are a result of damaged tissue when inflammation causes cells to create ...
Source: Fight Aging! - April 30, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

A Mechanism to Link Air Pollution and Cardiovascular Disease
Air pollution is associated with increased mortality and risk of a variety of age-related diseases, but as is often the case in human epidemiological data it isn't all that clear as how much of this is due to direct versus indirect effects. Lesser degrees of air pollution are associated with wealthier regions of the world, for example, and wealth in turn correlates with lower mortality and less age-related disease. That said, there are range of direct mechanisms for air pollution to impact long-term health, some with better accompanying evidence than others, such as the one explored here: Tiny particles in air pol...
Source: Fight Aging! - April 26, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

What Standing Rock Teaches Us About Environmental Racism And Justice
Access to clean, safe, and affordable drinking water is not just a concern of developing countries but of communities in our own backyard. The Standing Rock Sioux Tribe in North and South Dakota, for instance, relies on Lake Oahe, a 231-mile reservoir along the Missouri River, as its primary water source. In July 2016, the US Army Corps of Engineers approved the construction of the Dakota Access Pipeline (DAPL), a 1,172-mile duct that will carry crude oil from North Dakota to Illinois when completed, which will run underneath the Missouri River less than a mile north of the Standing Rock Sioux Reservation, including throug...
Source: Health Affairs Blog - April 17, 2017 Category: Health Management Authors: Ramon Jacobs-Shaw Tags: Featured Health Equity Population Health Public Health Quality Clean Water Rule Dakota Access Pipeline DAPL enironmental racism environmental equity Environmental Health Environmental Protection Agency Native Americans Standing R Source Type: blogs

Why President Trump Should Use Foreign Aid For Health To Make America Great
The Trump administration recently proposed to make major cuts to US foreign assistance, including the $10.3 billion a year that the federal government spends to advance global health through the National Institutes of Health (NIH), the Centers for Disease Control and Prevention, the US Agency for International Development (USAID), and the United Nations. As practitioners with more than 60 years of combined experience, we believe that the Trump administration is making a terrible mistake. Investing in global health is essential to the safety, security, and future prosperity of the United States, in addition to being a highl...
Source: Health Affairs Blog - April 17, 2017 Category: Health Management Authors: Robert Hecht and Sten Vermund Tags: Costs and Spending Featured Global Health Policy Population Health Public Health epidemics foreign aid humanitarian aid infectious diseases PEPFAR US foreign assistance Source Type: blogs

Fight Aging! Newsletter, April 17th 2017
This study assessed the prevalence of grey hair in patients with coronary artery disease and whether it was an independent risk marker of disease. This was a prospective, observational study which included 545 adult men who underwent multi-slice computed tomography (CT) coronary angiography for suspected coronary artery disease. Patients were divided into subgroups according to the presence or absence of coronary artery disease, and the amount of grey/white hair. The amount of grey hair was graded using the hair whitening score: 1 = pure black hair, 2 = black more than white, 3 = black equals white, 4 = white more t...
Source: Fight Aging! - April 16, 2017 Category: Research Authors: Reason Tags: Newsletters Source Type: blogs

The Dual Nature of Reactive Oxygen Species in Aging
Reactive oxygen species (ROS) are largely generated in the mitochondria of the cell, a side-effect of the energetic processes taking place there to power cellular operations. ROS cause damage that must be repaired by reacting with molecular machinery in the cell, and that stress on the cell increases with age, and features prominently in most discussions of aging. ROS also play an important role as signals, however, triggering important processes related as cellular maintenance. That exercise is beneficial, for example, depends upon an increase in ROS production, and a number of ways of increasing life span in laboratory s...
Source: Fight Aging! - April 11, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Bioterrorism: 10 facts about sarin gas
As the civil war in Syria shows no signs of de-escalating, worrisome evidence points towards the deployment of chemical warfare with banned agents recently, resulting in almost a hundred deaths with more than a quarter of them children. Chlorine and Sarin gas are primarily being implicated. Here are ten facts to know about Sarin gas and how it works. 1. Historically, Sarin was used for bioterrorism by members of Aum Shinrikyo, a radical religious cult group in Japan, in 1994 and 1995 that collectively poisoned 6500 people on the subway. In 1998, Saddam Hussein used it against Iranians and Kurdish people. The Syrian governm...
Source: Kevin, M.D. - Medical Weblog - April 9, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/tanu-s-pandey" rel="tag" > Tanu S. Pandey, MD < /a > Tags: Conditions Emergency Source Type: blogs

Research and Reviews in the Fastlane 178
LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the  178th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains  5 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Justin Morgenst...
Source: Life in the Fast Lane - April 6, 2017 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Intensive Care Pediatrics Procedure R&R in the FASTLANE Radiology Respiratory Resuscitation Toxicology and Toxinology Education emergency Emergency Medicine recommendations Review Source Type: blogs

OPDP Picks Up Steam on Enforcement Letters
After a fairly slow 2016, the United States Food and Drug Administration’s (FDA) Office of Prescription Drug Promotion (OPDP) issued a quick burst of letters in the span of nine days in December. This flurry of activity more than doubled the enforcement letters that had been issued up to that point in the year. Although there was an apparent increase in enforcement activity in December (perhaps related to the new Administration and the mark the old Administration wanted to leave on the industry), the type of activity and the nature of Draft Guidances issued in 2017 prior to the Trump Administration taking office ind...
Source: Policy and Medicine - April 5, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Penn Medicine Expert: Smoking May Be No More Hazardous than Vaping
An expert at Penn Medicine - the University of Pennsylvania's health care system - is telling the public that smoking cigarettes, like Marlboros, Camels, and Newports, may beno more hazardous to your health than vaping a tobacco-free e-liquid.According to the expert: "We know that cigarettes are unsafe after 40 years of exposure. We don ’t have 40 years of exposure to e-cigarettes to know what the danger is. We don’t know the safety profile, so we can’t say that e-cigarettes are safer than traditional cigarettes."The Rest of the StoryWell, if we can't say that e-cigarettes are safer than traditi...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - April 3, 2017 Category: Addiction Source Type: blogs

The Jittery Patient
​A 22-year-old woman with no past medical history presented to the emergency department with palpitations. She reported that she had ingested a handful of caffeine tablets with a large glass of wine two hours earlier. She reported feeling "stressed out" and wanting to hurt herself. The patient was alert but appeared anxious on arrival at the ED.Her blood pressure was 90/49 mm Hg, heart rate was 115 beats/min, respiratory rate was 20 breaths/min, and SPO2 was 100% on room air. An ECG showed sinus tachycardia at 120 beats/min with normal intervals. Shortly after arrival, her blood pressure dropped to 83/42 mm Hg,...
Source: The Tox Cave - March 31, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Research and Reviews in the Fastlane 177
This study has some frustrating findings: they looked at 318 patients who got a CTPA within 2 weeks of a negative CTPA and found a 5% positive rate. Is CTPA like a stress test, where we just can’t predict plaque rupture? Are people who get CTPAs people who other docs are also worried about PE? Or are we just ordering too many CTPAs? How many of these were false postives or negatives? Sadly, as with most clinical research on pulmonary embolism, I am let with more questions than answers (but we probably order too many CTPAs). Recommended by: Seth Trueger Pediatrics Luck RP, et al. Cosmetic outcomes of absorbable...
Source: Life in the Fast Lane - March 30, 2017 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Clinical Case Education Emergency Medicine Infectious Disease Intensive Care Pediatrics R&R in the FASTLANE Radiology Respiratory Resuscitation critical care research and reviews Source Type: blogs

Bit by the Research Bug: Priscilla ’s Growth as a Scientist
This is the third post in a new series highlighting NIGMS’ efforts toward developing a robust, diverse and well-trained scientific workforce. Credit: Christa Reynolds. Priscilla Del Valle Academic Institution: The University of Texas at El Paso Major: Microbiology Minors: Sociology and Biomedical Engineering Mentor: Charles Spencer Favorite Book: The Immortal Life of Henrietta Lacks, by Rebecca Skloot Favorite Food: Tacos Favorite music: Pop Hobbies: Reading and drinking coffee It’s not every day that you’ll hear someone say, “I learned more about parasites, and I thought, ‘This is so cool!...
Source: Biomedical Beat Blog - National Institute of General Medical Sciences - March 28, 2017 Category: Research Authors: Christa Reynolds Tags: Being a Scientist Bacteria BUILD Infectious Diseases Profiles Training Source Type: blogs

Where ’s the Buprenorphine asked Mr. Obvious? Thanks, CDC!
A quick note tonight, hopefully with a longer post to follow this weekend… I’ve been frustrated by the people behind the Wisconsin PDMP, or Prescription Drug Monitoring Program, for their mistakes related to buprenorphine. Whoever came up with the numbers made a rookie error when calculating the equivalent morphine dose of patients taking buprenorphine products. The error is easy to notice by anyone who works with the drug, but apparently difficult to grasp by anyone with the power to correct the database figures. Those people include, by the way, the folks at Brandeis University who give the numbers to Wiscon...
Source: Suboxone Talk Zone - March 22, 2017 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Benzos Buprenorphine pharmacology Public policy risks benzodiazepines CDC PDMP Source Type: blogs

Anti-Vaping Advocates Support Indoor Vaping Bans Because We Don't Know if Secondhand Vaping is Harmful
In an interesting twist from the usual reasoning in public health, anti-vaping advocates are promoting the enactment of policies that ban vaping in public places not because secondhand vaping has been shown to have serious health hazards, but because it hasn't been proven to be benign.In anopinion piece published inTobacco Control, Dr. Simon Chapman and colleagues support a ban on vaping in public places because we don't know yet whether secondhand vaping is harmful. The authors write that: " those advocating for vaping to be allowed in smoke-free public places centre their case on gossamer-thin evidence that vap...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - March 21, 2017 Category: Addiction Source Type: blogs

Dr. Janet Woodcock on the Opioid Epidemic
The United States Food and Drug Administration (FDA) offers a podcast series, known as the Director’s Corner, that features the director of the FDA Center for Drug Evaluation and Research (CDER). One of the most recent episodes featured an interview with Dr. Janet Woodcock, by Colleen Labbe from the CDER Office of Communications, who discussed the way the FDA has been addressing the opioid epidemic affecting many communities around the United States. CDER’s Response to FDA Labeling Changes One of the first questions asked of Dr. Woodcock was what, exactly, CDER did with regard to the various opioid safety lab...
Source: Policy and Medicine - March 20, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

A 20-something with DKA and a regular wide complex tachycardia
Medics were called to see a 20-something type 1 diabetic with h/o DKA who had altered mental status.He was found to have " Kussmaul " respirations and respiratory distress.He was not in shock, his blood pressure was adequate, and pulses were strong.He was put on the cardiac monitor:Regular wide complex tachycardia.A 12-lead ECG was recorded:Regular Wide complex tachycardia at a rate of 200.What do you think?If you're the medic, what would you do?Whenever there is a wide complex, especially in a patient with DKA, one should think of hyperkalemia (sinus rhythm, often with " invisible P-waves " ).However, ...
Source: Dr. Smith's ECG Blog - March 16, 2017 Category: Cardiology Authors: Steve Smith Source Type: blogs

New York State Department of Health Urges Physicians to Discourage Patients from Quitting Unless They Use Big Pharma Products and Tells Vapers They Might as Well Go Back to Smoking
The New York State Department of Health has sent out a letter to medical professionals in the state, urging them to discourage patients from quitting smoking using e-cigarettes, even if they indicate unwillingness or lack of interest in nicotine replacement therapy or other smoking cessation drugs.In the February 2017 letter, the state health commissioner writes:" I encourage all health care providers to talk to their patients -- young and old alike -- about the dangers of e-cigarettes and to discourage their use. For patients who are already using traditional cigarettes or e-cigarettes, there are currently seven FDA-...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - March 15, 2017 Category: Addiction Source Type: blogs

Estimating the economic burden of respiratory illness in the UK
This report finds that lung disease costs the economy £11 billion every year. Of this, almost £10 billion is spent on direct costs to the NHS: GP appointments, time in hospital, treatments and medication. It calls for the government to support the first ever taskforce for lung health.ReportBritish Lung Foundation - news (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - March 15, 2017 Category: UK Health Authors: The King ' s Fund Information & Knowledge Service Tags: Local authorities, public health and health inequalities NHS finances and productivity Source Type: blogs

Happy 12th birthday to the Health Business Blog
The Health Business Blog has turned 12 years old! Continuing a tradition I established with birthdays one, two, three, four, five, six, seven, eight, nine, ten and eleven I have picked out a favorite post from each month. Thanks for continuing to read the blog! March 2016: Health Wonk Review -Tales of the Trump My roundup of policy posts from the blogosphere took Trump seriously and literally. April 2016: Listen app – ResApp diagnoses respiratory ailments An Australian company developed a smartphone app to diagnose respiratory diseases by analyzing the sound...
Source: Health Business Blog - March 13, 2017 Category: Health Management Authors: dewe67 Tags: Announcements Blogs Source Type: blogs

Time spent in “green” places linked with longer life in women
In this study, those women that lived in greener spaces were more physically active. Living among trees, plants, grass, and flowers provides an environment with less pollution than one with low levels of vegetation. The plants can reduce levels of nitrogen dioxide and particulate matter, which lowers the level of pollution. In this study, death from respiratory disease was reduced by about one third in those women who lived in the homes with the highest amount of vegetation. Breathing clean air matters, and plants help to clean the air. Take advantage of green spaces If you live in an area with heavy vegetation, this is go...
Source: Harvard Health Blog - March 9, 2017 Category: Consumer Health News Authors: Elizabeth Pegg Frates, MD Tags: Behavioral Health Prevention Stress Women's Health Source Type: blogs

Infection and Inflammation in Neurodegenerative Conditions
Increased levels of chronic inflammation accompany aging, and this drives faster progression of a range of age-related conditions, spurring greater damage and loss of function in tissues. Researchers here ask to what degree this is due to opportunistic infections and a weakened immune system rather than being caused by the more general dysfunction and overactivation of the aged immune system that would occur even absent such infections, the state known as inflammaging. Like many such investigations, this serves to emphasize the need for effective means to rejuvenate the age-damaged immune system, such as through clearing a...
Source: Fight Aging! - March 9, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

A Demonstration in Mice of Whole Mitochondria Delivered as a Therapy
Mitochondria, the swarming power plants of the cell, become damaged and dysfunctional with age. Can this be addressed by delivering complete, whole, new mitochondria as a therapy? There have been signs in past years that cells can ingest and incorporate mitochondria from the surrounding environment, but few useful demonstrations to show whether or not this is common in living tissues. In the research here, researchers achieve that result, delivering mitochondria into tissues as a therapy, and using this approach to treat an animal model of Parkinson's disease. This neurodegenerative condition is associated with degraded mi...
Source: Fight Aging! - March 7, 2017 Category: Research Authors: Reason Tags: Daily News Source Type: blogs

Health Affairs ’ March Issue: Delivery System Innovation
The March issue of Health Affairs explores various aspects of delivery system innovation as it relates to efficiency, improved quality, better patient engagement, and a more satisfied clinical workforce. The issue was supported by Blue Shield of California Foundation, The Colorado Health Foundation, Missouri Foundation for Health, and New York State Health Foundation. YMCA of the USA interventions reduce Medicare spending and utilization The YMCA of the USA’s prediabetes intervention program saved Medicare an average of $278 per member per quarter over the first three years. Maria Alva of RTI International and coauth...
Source: Health Affairs Blog - March 6, 2017 Category: Health Management Authors: Health Affairs Tags: Elsewhere@ Health Affairs Health Affairs journal Source Type: blogs

The tricky thing about asthma
In mid-January, health headlines announced that nearly one-third of adults diagnosed with asthma don’t actually have this respiratory condition at all. This announcement appeared everywhere from Fox News Health to the Chicago Tribune. As a primary care doc, a medical writer, and an asthma sufferer, I was very skeptical of these dramatic announcements, and with good reason. An editorial that accompanied this study provides important perspective that suggests the news headlines were exaggerated and misleading. Taking a closer look at the study Let’s talk about the study, which is a good one, and has merit. Canadi...
Source: Harvard Health Blog - March 6, 2017 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Asthma and Allergies Lung disease Source Type: blogs