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OMI in a pediatric patient? Teenagers do get acute coronary occlusion, so don't automatically dismiss the idea.
Acute coronary syndrome in a pediatric patient?Written by Kirsten Morrissey, MD with edits by Bracey, Grauer, Meyers, and Smith An older teen was transferred from an outside hospital with elevated serum troponin and and ECG demonstrating ST elevations. The patient was obese and had a medical history of only recurrent tonsillitis status post tonsillectomy and adenoidectomy but was otherwise healthy and fully vaccinated. He reported 1.5 days of chest pain that started as substernal and crushing in nature awakening him from sleep and occasionally traveling to right side of neck. The pain ...
Source: Dr. Smith's ECG Blog - December 5, 2023 Category: Cardiology Authors: Bracey Source Type: blogs

THCB 20th Birthday classics: A Brief History of Price Controls by Annoyed Republican Administrations
By UWE REINHARDT One of the greatest pleasures of running THCB has been to get to know and host the writings of some of my health policy heroes. This week I have already published work from Jeff Goldsmith, and Ian Morrison & Michael Millenson among others will be featured next week (as the party won’t quite stop). Perhaps one of the most amazing things was that the doyen of health economists, Uwe Reinhardt, offered to write some original pieces for THCB…prodded by former editor John Irvine. This is one of my favorites, riffing on a talk I heard him give in (I think) 1993 about how HCFA was like the Kreml...
Source: The Health Care Blog - August 18, 2023 Category: Consumer Health News Authors: matthew holt Tags: Health Policy Price controls Uwe Reinhardt Source Type: blogs

Painless Nasogastric Tube Placement
A 6-year-old boy presented with intermittent abdominal pain, nausea, and vomiting. Because his abdominal examination was unremarkable, the pain intermittent, and constipation a possibility, we provided an enema along with an abdominal pain workup but no radiographs. His pain improved, the abdominal labs were unremarkable, and the child tolerated an oral fluid challenge after treatment with ondansetron.The mother was advised at discharge to return if she became concerned about her child's condition. They did return a few hours later for increased vomiting and abdominal pain. A CT scan demonstrated multiple dilated loops ...
Source: M2E Too! Mellick's Multimedia EduBlog - March 1, 2022 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Why Isn ’ t Price Transparency Working in Healthcare?
By TAYLOR CHRISTENSEN, MD I strongly believe that getting people the information and incentives necessary to choose higher-value providers and insurers is the solution to improving value in healthcare (see my Healthcare Incentives Framework). But, you say, we’ve tried that and it doesn’t work, and current efforts are a waste of time! Here’s an example of some great research that you might use to support your opinion: Examining a Health Care Price Transparency Tool: Who Uses It, and How They Shop for Care (Sinaiko and Rosenthal, Health Affairs, April 2016) The news media would see this and...
Source: The Health Care Blog - November 7, 2019 Category: Consumer Health News Authors: Christina Liu Tags: Patients The Business of Health Care price transparency TAYLOR CHRISTENSEN Source Type: blogs

Viral Agents of Childhood Respiratory Tract Infection in the United States
As of October, 2019 Gideon www.GideonOnline.com and the Gideon e-book series contain details of 69,204 epidemiological surveys – of which 1,107 (1.6%) are related to the prevalence of specific viral species in patients with respiratory tract infection. [1-3] The following chronology of published studies summarizes the relative proportion of viral agents associated with non-influenza childhood respiratory infection in the United States. Additional details and primary references are available on request. 1976 – 2001 Tennessee hMPV accounted for 20% of acute respiratory illness among children ages 0 to 5 years having ...
Source: GIDEON blog - October 25, 2019 Category: Databases & Libraries Authors: Dr. Stephen Berger Tags: Ebooks Epidemiology ProMED Source Type: blogs

Safer surgery: Steps you can take
Chances are high that most of us will have a surgical procedure at some point during our lives. Estimates based on 2002 data in three states suggest Americans have a lifetime average of nine surgical procedures. In 2010 in the United States, there were an estimated 1.4 million inpatient procedures, ranging from childhood tonsillectomies, breast lumpectomies, and gallbladder removal to cataract surgeries, hernia repairs, and hip or knee replacements. And the rate of surgical procedures continues to rise. So it’s valuable to know what you can do to make safer surgery and a successful outcome more likely. How do I choos...
Source: Harvard Health Blog - March 28, 2019 Category: Consumer Health News Authors: Susan Abookire, BSEE, MD, MPH, FACP Tags: Health Managing your health care Safety Surgery Source Type: blogs

Jahi McMath, Race, and Bioethics
Twice upon a time, there was a girl who died. The death certificate that New Jersey issued to 17-year-old Jahi McMath on June 22 was the second one issued for her. California issued McMath’s first death certificate in December 2013. McMath had been admitted to Children’s Hospital Oakland on December 9 for a routine tonsillectomy… Read more The post Jahi McMath, Race, and Bioethics appeared first on The Hastings Center. (Source: blog.bioethics.net)
Source: blog.bioethics.net - July 19, 2018 Category: Medical Ethics Authors: Susan Gilbert Tags: Health Care bioethics Brain Death Chronic Conditions and End of Life Care Hastings Bioethics Forum Health and Health Care Jahi McMath race syndicated Source Type: blogs

A Physician Who Had Run Clinics Which Proselytized Patients is Now a Government Health Care Leader Positioned to Enforce Her Religious Beliefs on Patients and Citizens Who Do Not Hold Such Beliefs
DiscussionDr Foley is certainly entitled to her religious views. She is also entitled as a physician to avoid situations in which normal standards of care would push her to provide services to patients that conflict with her religious conviction. But she is not entitled as a physician to proselytize in the guise of medical practice.Furthermore, as a leader in a government health agency, she is not entitled to use that agency ' s power to enforce her personal religious beliefs on patients who do not hold such beliefs. Given her career, though, there is every reason to worry that she will do so. Furth...
Source: Health Care Renewal - July 15, 2018 Category: Health Management Tags: core values deception DHHS Donald Trump mission-hostile management Source Type: blogs

Funtabulously Frivolous Friday Five 242
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF…introducing Funtabulously Frivolous Friday Five 242. Readers can subscribe to FFFF RSS or subscribe to the FFFF weekly EMAIL Question 1 Is stuttering more common in boys or girls? Reveal Answer expand(document.getElementById('ddet85544164'));expand(document.getElementById('ddetlink85544164')) Boys. With onset u...
Source: Life in the Fast Lane - June 22, 2018 Category: Emergency Medicine Authors: Mark Corden Tags: Frivolous Friday Five ASS Austin flint austin flint murmur botulism botulus breath sounds broncho-vesicular King George VI sausage stuttering TLA TOF tonsil guillotine Source Type: blogs

Does your child need a tonsillectomy?
Follow me on Twitter @drClaire Tonsillectomies are one of the most common surgeries performed on children — but the decision to do one should not be taken lightly. In 1965, there were about a million tonsillectomies (with or without adenoidectomy, a surgery often done at the same time) performed on children younger than 15 years old. By 2006 that number had dropped by half, and by 2010 it had dropped by half again. Why the drop? Well, complications are common. In fact, one in five children who have a tonsillectomy has a complication. The most common is breathing difficulty, which can affect one in 10. Bleeding affects on...
Source: Harvard Health Blog - March 20, 2018 Category: Consumer Health News Authors: Claire McCarthy, MD Tags: Children's Health Ear, nose, and throat Parenting Surgery Source Type: blogs

Does the possibility of misdiagnosis make the concept of brain death invalid?
Recently I read the detailed account of what has happened with Jahi McMath, titled “What Does It Mean to Die?” in the most recent issue of The New Yorker. It made me reassess what I think about the concept of brain death. Four years ago, Jahi McMath was a thirteen-year-old African American girl who had a tonsillectomy to treat severe sleep apnea. She had a... // Read More » (Source: blog.bioethics.net)
Source: blog.bioethics.net - February 1, 2018 Category: Medical Ethics Authors: Steve Phillips Tags: Health Care bioethics end of life syndicated Source Type: blogs

A Brief History of Price Controls by Annoyed Republican Administrations
By UWE REINHARDT Although, unlike most other nations, the U.S. has only two parties worth the name, their professed doctrines compared with their actions strikes me as more confusing than the well-known S.sky Decomposition which, as everyone knows, can be derived simply from a straightforward application of Kramer’s rule to a matrix of second partial derivatives of a multivariable demand function. The leaders of the drug industry, for example, probably are now breaking out the champagne in the soothing belief that their aggressive pricing policies for even old drugs are safe for at least the next eight years from the al...
Source: The Health Care Blog - November 15, 2017 Category: Consumer Health News Authors: John Irvine Tags: THCB Trending Source Type: blogs

Is the Direct Primary Care Model Dead?
By NIRAN AL-AGBA, MD A recent Medical Economics article asked “Is the DPC model at risk of failing?” The piece focuses on two large DPC-like organizations, Qliance Medical Management of Seattle, Washington and Turntable Health of Las Vegas, NV, working in partnership with Iora Health, which recently closed their doors. Qliance and Turntable were not actually DPC practices by strict definition; they were innovative large business operations providing healthcare services to patients and excluding third party payers. Their idea was commendable, but their closure indicates little cause for concern in regard to the growing ...
Source: The Health Care Blog - June 6, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Qliance Turntable Health 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 indicat...
Source: Policy and Medicine - April 5, 2017 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

U.S. Public Policy Versus the S.sky Decomposition
By UWE REINHARDT Although, unlike most other nations, the U.S. has only two parties worth the name, their professed doctrines compared with their actions strikes me as more confusing than the well-known S.sky Decomposition which, as everyone knows, can be derived simply from a straightforward application of Kramer’s rule to a matrix of second derivatives of a multivariable demand function. The leaders of the drug industry, for example, probably are now breaking out the champagne in the soothing belief that their aggressive pricing policies for even old drugs are safe for at least the next eight years from the allegedly ...
Source: The Health Care Blog - November 22, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs