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Tropical Travel Trouble 008 Total TB Extravaganza
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 Tropical Travel Trouble 008 Peer Reviewer Dr McBride ID physician, Wisconsin TB affects 1/3rd of the population and one patient dies every 20 seconds from TB. Without treatment 50% of pulmonary TB patients will be dead in 5 years. In low to middle income countries both TB and HIV can be ubiquitous, poor compliance can lead to drug resistance and malnourished infants are highly susceptible. TB can be very complex and this post will hopefully give you the backbone to TB m...
Source: Life in the Fast Lane - June 16, 2018 Category: Emergency Medicine Authors: Neil Long Tags: Clinical Cases Tropical Medicine Genexpert meningitis TB TB meningitis Tuberculosis Source Type: blogs

Supporting Families in Milk Sharing as an International Board Certified Lactation Consultant
This article originally appeared on http://www.ambermccann.com/.
Source: Disruptive Women in Health Care - August 27, 2013 Category: Health Medicine and Bioethics Commentators Authors: dw at disruptivewomen.net Tags: Access Advocacy Alternative Medicine Childbirth Children Guest Posts Nutrition Uncategorized Source Type: blogs

Transforming Rural Health Care: High-Quality, Sustainable Access To Specialty Care
Editor’s note: This post is also authored by Kate Samuels, a project manager at Brookings. It is informed by a case study, the fourth in a series made possible through the Merkin Initiative on Physician Payment Reform and Clinical Leadership, a special project to develop clinician leadership in health care delivery and financing reform. The case study will be presented on Monday, December 8 using a “MEDTalk” format featuring live story-telling and knowledge-sharing from patients, providers, and policymakers. Health care for patients in rural communities across the United States remains a unique challenge.  Des...
Source: Health Affairs Blog - December 5, 2014 Category: Health Management Authors: Kavita Patel, Margaret Darling, and Mark McClellan Tags: All Categories Connected Health Disparities Health Care Delivery Health IT Payment Physicians Policy Primary Care Quality Workforce Source Type: blogs

Survey of Immunization Practices in Patients With Inflammatory Bowel Disease Among Pediatric Gastroenterologists
Conclusions: There is practice variation among pediatric gastroenterologists in assessment of immunizations in patients with inflammatory bowel disease, including the specific vaccines assessed, and timing and method of assessment. Inability to coordinate care, access immunization records, and offer vaccines through their medical practice are barriers to adhering to immunization guidelines.
Source: Journal of Pediatric Gastroenterology and Nutrition - July 1, 2015 Category: Gastroenterology Tags: Original Articles: Gastroenterology Source Type: research

Barriers to Linkage to Care for Hepatitis B Virus Infection: A Qualitative Analysis in Burkina Faso, West Africa.
Abstract Hepatitis B virus (HBV) infection is a critical global health problem. The World Health Organization (WHO) has recently developed a global elimination strategy for HBV infection. Increasing access to screening, liver assessment, and antiviral treatment are crucial steps in achieving this goal. Little is known, however, about obstacles to linkage to care in low- and middle-income countries. Using a grounded theory approach, this qualitative study sought to characterize the diagnostic itineraries of people with chronic HBV infection in Burkina Faso, a west African country with high HBV prevalence, to identi...
Source: The American Journal of Tropical Medicine and Hygiene - December 6, 2016 Category: Tropical Medicine Authors: Giles-Vernick T, Hejoaka F, Sanou A, Shimakawa Y, Bamba I, Traoré A Tags: Am J Trop Med Hyg Source Type: research

Tropical Travel Trouble 009 Humongous HIV Extravaganza
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 Tropical Travel Trouble 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease and demystify some of the potential diseases you need to consider in those who are severely immunosuppressed. While trying to be comprehensive this post can not be exhaustive (as you can imagine any patient with a low ...
Source: Life in the Fast Lane - July 7, 2018 Category: Emergency Medicine Authors: Amanda McConnell Tags: Clinical Cases Tropical Medicine AIDS art cryptococcoma cryptococcus HIV HIV1 HIV2 PEP PrEP TB toxoplasma tuberculoma Source Type: blogs

The Cost of Public Reporting
ANISH KOKA MD In an age where big data is king and doctors are urged to treat populations, the journey of one man still has much to tell us. This is a tale of a man named Joe. Joseph Carrigan was a bear of a man – though his wife would say he was more teddy than bear.  He loved guitar playing,  and camp horror movies.  Those who knew him well said he had a kind heart, a quick wit and loved cats. I knew none of these things when I met Joe in the Emergency Department on a Sunday afternoon.  I had been called because of an abnormal electrocardiogram – the ER team was worried he could be having a heart attack. ...
Source: The Health Care Blog - September 18, 2017 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Source Type: blogs

The High Cost of Public Reporting
ANISH KOKA MD In an age where big data is king and doctors are urged to treat populations, the journey of one man still has much to tell us. This is a tale of a man named Joe. Joseph Carrigan was a bear of a man – though his wife would say he was more teddy than bear.  He loved guitar playing,  and camp horror movies.  Those who knew him well said he had a kind heart, a quick wit and loved cats. I knew none of these things when I met Joe in the Emergency Department on a Sunday afternoon.  I had been called because of an abnormal electrocardiogram – the ER team was worried he could be having a heart attack. ...
Source: The Health Care Blog - September 18, 2017 Category: Consumer Health News Authors: anish_koka Tags: Uncategorized Cardiac surgery High-risk Quality Reporting Source Type: blogs

PhRMA Members Invested $58.8 Billion in R&D in 2015
In 2015, PhRMA member companies invested $58.8 billion in research and development, up 10.3% from 2014. The new R&D data is based on findings from the 2016 PhRMA annual member survey released in the 2016 Biopharmaceutical Research Industry Profile and the corresponding industry chart pack, Biopharmaceuticals in Perspective, which highlighted the wide-reaching impact of PhRMA member companies on the economy and biopharmaceutical innovation. In the United States, the biopharmaceutical industry is a driver of economic growth and global competitiveness, and is the most research-intensive sector of the economy. The biopharmac...
Source: Policy and Medicine - June 16, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

The clinical characteristics and the features of immunophenotype of peripheral lymphocytes of adult onset chronic active Epstein-Barr virus disease at a Tertiary Care Hospital in Beijing
In this study, CAEBV patients had decreased B cell, NK cell, CD4 cell and CD8 cell counts. The prevalence of low level of B cells, NK cells, CD4 cells was relatively higher than reported ever. Chinese adult onset CAEBV patients have different clinical characteristics and are featured by an immunosuppression status as demonstrated by decreased B cell, NK cell, CD4 cell and CD8 cell.
Source: Medicine - March 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

‘ Going to Extremes ’ Hall of Fame
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog In 2012, Greg Kelly suggested that LITFL collate the most extreme ‘medical extremes’. This is how things currently stand: ParameterLevelDiagnosisSubmitted by Ammonia514 umol/LTorsten Behrens Base excess (postive)40.6 mmol/LChronic Type 2 respiratory failureJakob Mathiszig-Lee Bilirubin1113 umol/lDrug-induced hepatitis (anabolic steroids)Jurij Hanžel Blood pressure345/245 mmHgDuring weightlifting (P. Palatini et al, 1989: https://www.ncbi.nlm....
Source: Life in the Fast Lane - April 21, 2018 Category: Emergency Medicine Authors: Chris Nickson Tags: Emergency Medicine Intensive Care Investigation extremes hall of fame Investigations parameters Physiology Source Type: blogs

Primary Care Evaluation of a Hepatitis C Virus (HCV) Screening Education Intervention
This study looked at screening rates before and after an educational intervention which happened subsequent to the activation of an EMR alert. Whereas HCV EMR alerts showed an increase in HCV screenings before the education intervention, the addition of the education showed a modest increase in HCV screening rates for Baby Boomer patients.
Source: Journal of the American Board of Family Medicine - October 18, 2022 Category: Primary Care Authors: Ludden, T., Shade, L., Thomas, J., Russo, M. W., Leonard, M., Zamor, P. J., Patterson, C. G., Tapp, H. Tags: Original Research Source Type: research

Quiz Page March 2013: A Critically Ill Infant With Sepsis, Respiratory Failure, and Anasarca
A 1-month-old full-term male infant presented with decreased activity, poor appetite, and abdominal distension. Serologic testing during the first trimester of pregnancy showed that the mother was nonreactive upon rapid plasma reagin (RPR) testing, was rubella immune, and had negative results for hepatitis B and C, toxoplasma, and human immunodeficiency virus (HIV) tests. Vaginal/cervical specimens were negative for chlamydia, gonorrhea, and streptococcus group B. On admission, the infant's weight was 3.6 kg, height was 48.5 cm, rectal temperature was 94.7°F, heart rate was 150 beats/min, respiratory rate was 68 breaths/m...
Source: American Journal of Kidney Diseases - February 18, 2013 Category: Urology & Nephrology Authors: Juan C. Kupferman, Eric D. Spitzer, M. Barry Stokes Source Type: research

IMS Releases 2016 Report on Prescription Drug Spending – Net Price Growth 2.8% in 2015
Discussion on Medicare Part B Drug Payment Model Demonstration 
Source: Policy and Medicine - May 1, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

A Libertarian ’ s Case Against Free Markets in Health Care
By ROMAN ZAMISHKA In the final act of Shakespeare’s Richard III, the eponymous villain king arrives on the battlefield to fight against Richmond, who will soon become Henry VII. During the battle, Richard is dismounted as his horse is killed and in a mad frenzy wades through the battlefield screaming “A horse, a horse! My kingdom for a horse!” Richard shows us how market value can change drastically depending on the circumstances, or your mental state, and even the most absurd exchange rate can become reasonable in a moment of crisis. This presumably arbitrary nature of prices should be the first thing...
Source: The Health Care Blog - August 2, 2018 Category: Consumer Health News Authors: at RogueRad Tags: Economics Free Market health economics Libertarian Source Type: blogs