The Mechanics of Kidney Aging
As examinations of aging go, this open access overview of kidney decline and kidney disease is more focused on the mechanics of the problem than most, which makes it an interesting read. As a bonus, it opens by touching on the thorny topic of whether aging is a disease, and where the arbitrary boundary lies between aging and disease. Kidney disease is not as large a problem in our species as heart disease and cancer, but that is only because most people are killed by something else first. Age-related fibrosis eats away at kidney tissue until there is no longer enough left fully functional to do its job. It is an unpleasant...
Source: Fight Aging! - April 3, 2017 Category: Research Authors: Reason Tags: Daily News 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 traditional cigarettes, t...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - April 3, 2017 Category: Addiction 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-appro...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - March 15, 2017 Category: Addiction 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. Canadian resea...
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
Without Evidence, NIH Director Claims E-Cigarettes Cause Respiratory Infections and Asthma
In acommentary by the director of the National Institutes of Health (NIH), it is claimed that electronic cigarettes cause respiratory infections and asthma. According to the NIH director:" E-cigarettes come with their own health risks, including lung inflammation, asthma, and respiratory infections. "The Rest of the StoryThere is clinical evidence that vaping causes lung inflammation, so that part of the statement is supported by evidence. Specifically, vaping can causelung irritation, leading to short-term increases in airway resistance as measured by sensitive technology, although not apparent by routine spirometry. Whet...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - February 2, 2017 Category: Addiction Source Type: blogs
MKSAP: 24-year-old woman with sickle cell anemia
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 24-year-old woman undergoes routine evaluation. She is pregnant at 12 weeks’ gestation. Medical history is notable for homozygous sickle cell anemia (Hb SS). She has had multiple uncomplicated painful crises treated at home with hydration, nonopioid analgesia, and incentive spirometry. She requires hospital management for these episodes approximately twice per year. She has declined the use of hydroxyurea. Her only other medication is folic acid.
On physical examination, vital signs are normal. Mild scle...
Source: Kevin, M.D. - Medical Weblog - January 21, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Hematology Source Type: blogs
I Really Wonder How This Nonsense Proposal Ever Saw The Light Of Day.
I spotted this last week.Trial to give pharmacists more power over scriptsAntony Scholefield | 12 January, 2017 | Pharmacists will be free to change medication doses, issue repeat scripts and perform point-of-care tests for patients with chronic diseases under a trial starting this year.Running for 18 months, the Victorian trial is a way of freeing up GP time to deal with complex clinical issues, according to the state government.Supporters argue the trial will not fragment care and GPs will retain control over what happens to patients.The GPs taking part will write shared care plans that will guide pharmacists in mon...
Source: Australian Health Information Technology - January 19, 2017 Category: Information Technology Authors: Dr David More MB PhD FACHI Source Type: blogs
MKSAP: 62-year-old man is evaluated for declining exercise capacity
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 62-year-old man is evaluated for declining exercise capacity over the past year. He was diagnosed with moderate COPD 3 years ago. His symptoms had previously been well controlled with tiotropium and as-needed albuterol. He has not had any hospitalizations. He is adherent to his medication regimen, and his inhaler technique is good. He quit smoking 2 years ago. All immunizations are up to date, including influenza and pneumococcal vaccination. A chest radiograph performed 3 months ago for increased cough and sp...
Source: Kevin, M.D. - Medical Weblog - August 13, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Pulmonology Source Type: blogs
Eating Corn Flakes is Half as Dangerous as Smoking, According to Reasoning of Anti-Vaping Researchers
Based on evidence that chemicals often found in e-cigarette aerosol produce endothelial dysfunction and decreased arterial compliance, Dr. Aruni Bhatnagar of the University of Louisville has concluded that e-cigarettes are no safer than real cigarettes, and Dr. Stan Glantz has argued that vaping is up to half as dangerous as smoking. Both of these anti-vaping researchers reasoned that since the dose-response relationship between smoking and cardiovascular disease is non-linear and risk saturates at rather low levels of exposure, and since e-cigarettes contain chemicals that can cause acute cardiovascular injury, vaping is ...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - July 12, 2016 Category: Addiction Source Type: blogs
Research and Reviews in the Fastlane 139
This study is a reanalysis of the data, attempting to identify the threshold where the benefit in functionality is produced, using ranges of <160, 160–169, 170–179, 180–189, and ≥190 mm Hg. The outcome was Rankin Scale at 90 days. Although the ranges proposed by the authors only include a <160 as the lowest, the linear analysis of SBP and Rankin Score shows a direct correlation going as low as 130-139mmHg, therefore the authors conclude that 130-139mmHg for SBP is the optimal range for management of patients with ICH.
The study is a post-hoc analysis of a previous large study (open and unblinded) making no ...
Source: Life in the Fast Lane - June 23, 2016 Category: Emergency Medicine Authors: Soren Rudolph Tags: Clinical Research Education Emergency Medicine R&R in the FASTLANE Resuscitation Trauma Clinical Case critical care research and reviews Source Type: blogs
From Pilot to Policy: Lessons from e-Health Deployed at Scale
As mentioned in previous posts, the United4Health project was intended to test the deployment at scale of mobile health solutions and to integrate those telehealth services as part of the standard of care. Participants took this to heart and used the project to help tackle larger issues of policy, funding, technology, resources and overall workflow.
The following interview explores some of these larger issues, specifically: the need to realign payment models, challenges around the adoption of communications and data standards, the role of test and certification bodies like Continua, overcoming systems integration challe...
Source: Medical Connectivity Consulting - May 26, 2016 Category: Information Technology Authors: Bridget Moorman Tags: Mobile Health Source Type: blogs
American Lung Association Disseminates Negligent Medical Advice About Vaping
The president of the American Lung Association yesterday disseminated negligent medical advice regarding vaping through a tweet that included advice from six physicians.Each of these six physicians provides negligent medical advice regarding smoking cessation using electronic cigarettes.1. Chicago: This advice is negligent because it misrepresents the benefit-risk profile of electronic cigarette use for the individual patient. The physician is telling all smokers that the risks of trying e-cigarettes outweighs the potential benefits. But this is not at all consistent with the science. The science unequivocally demonstrates...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - May 18, 2016 Category: Addiction Source Type: blogs
Case Study: Sensor Selection for Remote Monitoring
In a previous blog post, I highlighted general principles for implementing and scaling systems to support remote monitoring of chronic conditions, namely congestive heart failure (CHF), Diabetes Mellitus (Type II Diabetes) and chronic obstructive pulmonary disease (COPD). In this blog post I will focus on COPD as a case study for the development, implementation and scaling of a remote monitoring system.
Definition of COPD
The World Health Organization (WHO) defines COPD as a “…lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible [̷...
Source: Medical Connectivity Consulting - May 10, 2016 Category: Information Technology Authors: Bridget Moorman Tags: Mobile Health Source Type: blogs
MKSAP: 61-year-old woman with progressive dyspnea and fatigue
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 61-year-old woman is evaluated for a 4-month history of progressive dyspnea and fatigue without chest pain. Eighteen months ago, she was diagnosed with liver cirrhosis due to nonalcoholic steatohepatitis (NASH). Medical history is also significant for obesity. Medications are propranolol, spironolactone, and lactulose.
On physical examination, temperature is 36.4 °C (97.5 °F), blood pressure is 112/64 mm Hg, pulse rate is 60/min, and respiration rate is 16/min; BMI is 36. Mild scleral icterus is noted. Cardi...
Source: Kevin, M.D. - Medical Weblog - May 7, 2016 Category: Journals (General) Authors: mksap Tags: Uncategorized Source Type: blogs
Major EU Remote Monitoring Pilot Results
This post looks at some lessons learned from remote monitoring projects in Europe. This and subsequent posts are based on my last eight years of supporting these projects combined with some thoughts from my implementation experience of technology systems in many different scenarios over the last thirty years. I hope that some of it will be of value to the readers wherever they are in the healthcare industry delivery chain.
Overview
I’m finishing up support of two long-term projects based in Europe that are focused on using remote monitoring technologies and integrated platforms to support chronic disease manage...
Source: Medical Connectivity Consulting - March 17, 2016 Category: Information Technology Authors: Bridget Moorman Tags: Care Delivery Remote Monitoring Source Type: blogs
