Research and Reviews in the Fastlane 135
Welcome to the 135th 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 6 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Justin Morgenstern, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R ...
Source: Life in the Fast Lane - May 18, 2016 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Disaster Education Emergency Medicine Intensive Care Neurology Pediatrics Pre-hospital / Retrieval Respiratory Resuscitation critical care R&R in the FASTLANE recommendations research and reviews Source Type: blogs
The Quality of Virtual Visits
By JOE KVEDAR, MD
Virtual visits are increasingly the rage amongst forward-thinking healthcare providers that want to jump on the telehealth band wagon. Extending the office visit across distance, using the same technology we use to keep in touch with loved ones (videoconferencing such as Skype and FaceTime), is a safe and logical way for providers to venture into a new tech-enabled world that may still be scary for some.
One way to think of this trend is to consider virtual visits an extension of the brick and mortar care model made famous a decade ago by companies like Minute Clinic. Offer convenient access to a care...
Source: The Health Care Blog - May 17, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Kvedar Quality measurement Virtual Visits Source Type: blogs
FDA warns that fluoroquinolone antibiotics can cause damage to muscles and nerves
The FDA updated boxed warning will inform patients that the serious side effects of the drugs generally outweigh the benefits for patients with sinusitis, bronchitis and uncomplicated urinary tract infections - if patients have other treatment options. However, why would you prescribe these antibiotics if there are other treatment options? The practical implication of this recommendation is somewhat unclear.The side effects can involve damage to tendons, muscles, joints, nerves and the central nervous system (CNS). There was an association between fluoroquinolone antibiotic use and disabling peripheral neuropathy in a 2013...
Source: Clinical Cases and Images - Blog - May 14, 2016 Category: Universities & Medical Training Tags: Medications Source Type: blogs
The story of an exhausted doctor daughter
I am a doctor daughter. I am exhausted. My emotions are bubbling close to the surface, and I fear that at any moment, someone will do or say something to me that will cause me to lose control, which I’m not allowed to do because I’m also a female physician in a leadership role, and our emotions must be held in check.
I watched one of my mentors be memorialized last week after he lost his battle with cancer. This week, I will watch my father, a man who has meant more to me in my life than any other except my husband, go through a revision prostate surgery, a bone marrow biopsy, and an inpatient stay for a urinary tract ...
Source: Kevin, M.D. - Medical Weblog - May 12, 2016 Category: Journals (General) Authors: Shelley W. Collins, MD Tags: Physician Cancer Pediatrics Source Type: blogs
Research and Reviews in the Fastlane 132
This article reviews 10 myths about the UA and UTIs. A common theme that permeates the article is that an abnormal UA is not diagnostic of a UTI: symptoms must be present as well since a significant portion of patients will have chronic colonization. A good lesson to keep in mind the next time you work clinically.
Recommended by: Anand Swaminathan
Emergency Medicine, Neurology
Friedman BW et al. The association between headache and elevated blood pressure among patients presenting to an ED. The American journal of emergency medicine. 32(9):976-81. 2014. PMID: 24993684
More data that BP & HA aren’t related. ...
Source: Life in the Fast Lane - April 29, 2016 Category: Emergency Medicine Authors: Justin Morgenstern Tags: Education Emergency Medicine Gastroenterology Neurology Pediatrics Psychiatry and Mental Health R&R in the FASTLANE EBM literature recommendations research and reviews Resuscitation Source Type: blogs
Dementia and comorbidities: ensuring parity of care
This report, supported by Pfizer, argues that a failure to prevent, diagnose and treat depression, diabetes and urinary tract infections in people with dementia could cost the UK's health and care system up to nearly £1 billion per year. It highlights a lack of parity in the diagnosis of these conditions in people with dementia and outlines some recommendations including revision of NICE clinical guidelines; greater patient involvement in care plans; and commissioning of a wider range of psychological therapies.
Report
Press release (Source: Health Management Specialist Library)
Source: Health Management Specialist Library - April 14, 2016 Category: UK Health Authors: The King's Fund Information & Knowledge Service Tags: Commissioning Patient involvement, experience and feedback Quality of care and clinical outcomes Source Type: blogs
Health Affairs March Issue: The Evolving Landscape Of Physician Practice
The March issue of Health Affairs explores public and private measures for reporting quality data in the health care system. The issue also contains several studies pertaining to value in the health care system, including collection and tracking of quality data, hospital participation in accountable care organizations, prescription drug benefits, and others.
This month’s DataGraphic provides a pictorial view of key facts about the changing landscape of physician practice.
The March issue of Health Affairs was supported in part by The Physicians Foundation.
Common Physician Practice Specialties Spend $15.4 Billion Annuall...
Source: Health Affairs Blog - March 7, 2016 Category: Health Management Authors: Lucy Larner Tags: Elsewhere@ Health Affairs Featured Health Affairs journal physicians perspective Source Type: blogs
Urinary Tract Infections in Older Men via Now@NEJM
Posted on infosnack. (Source: Kidney Notes)
Source: Kidney Notes - February 12, 2016 Category: Urology & Nephrology Authors: Joshua Schwimmer Source Type: blogs
A Year in Review: FDA 2015 New Drug Approvals
The approval of first-of-a-kind drugs rose last year to forty-one, resulting in the highest level of newly approved U.S. drugs in nineteen years. The total number of new drugs approved last year was even higher at sixty-nine. The rising figures reflect an industry-wide desire to research and develop drugs for rare and hard-to-treat diseases.
The newly approved drugs serve to advance medical care and the health of patients suffering from many ailments, including various forms of cancer, heart failure, and cystic fibrosis. Additionally, more than 40% of the new therapies were approved for treatment of rare or "orphan" dise...
Source: Policy and Medicine - January 13, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
On The Pulse - 08th January 2016
Avoiding antibiotics in urinary tract infections (Source: OnMedica Blogs)
Source: OnMedica Blogs - January 8, 2016 Category: Journals (General) Source Type: blogs
Reduction in Hospital Errors—Progress, But Still Not Enough
By STEVE FINDLAY
Fifteen years after the landmark IOM report To Err is Human, we still haven’t figured out how to count medical errors and iatrogenic harm—let alone sharply reduce them. The debate surrounding this persists, as it must. For example, see the dialogue on THCB between Anish Koka and John James on the often-used figure of 400,000 deaths per year from medical errors. See also this Health Affairs blog from 2012 by Michael Millenson.
A simple answer to why it’s so hard to count medical errors, harm and deaths is that—well, it’s just a damn hard thing to do. Think about it: how on earth would we document...
Source: The Health Care Blog - December 5, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB Steve Findlay Source Type: blogs
When will we start taking mental health seriously?
As a fourth-year medical student in a sub-internship in internal medicine, I have something that no doctor in America has. I have as much time as I want to spend with my patients. Don’t get me wrong, I am still a student. I’m still paying hospitals to let me be there, and I only have a maximum of four patients per day, but I inevitably end up spending more time with each patient than the average resident.
Today, I spent my time with one patient in particular. She was a Caucasian woman who was a previous intravenous drug abuser who has been sober for fifteen years. She is on methadone and takes Xanax for anxiety. She pr...
Source: Kevin, M.D. - Medical Weblog - November 25, 2015 Category: Journals (General) Authors: Marc N. Katz Tags: Conditions Hospital Psychiatry Source Type: blogs
Why older adults need geriatricians
In his post, “The geriatrician shortage: The problem isn’t what you think,” I completely agree that the current gap in health care professionals’ skills to care well for our aging population is exceedingly complex, reaching well beyond lack of medical school training or funding. Funding for graduate medical education needs to be transformed to match the workforce needs of the nation, with special attention to filling workforce gaps in rural areas. Other health professions (nursing, pharmacy, social work, rehabilitation, and many others) need to enhance geriatric competencies in their schools and residenc...
Source: Kevin, M.D. - Medical Weblog - November 25, 2015 Category: Journals (General) Authors: Elizabeth Eckstrom, MD Tags: Physician Geriatrics Primary care Source Type: blogs
The Anatomy Of A Home Death Without Hospice
Although his family was convinced that it was the metastatic prostate cancer that would eventually lead to his demise, I had my doubts. His dementia had progressed to the point that he spent all his days in bed. He could no longer navigate the most simple activities of daily living. His caregiver fed him, dressed him, cleaned him up after he went to the bathroom. I visited him in the home. We met eight months before his death. His wife, two daughters, and I. We discussed what dying looked like. We talked of dignity, and what decisions he would make if he had the ability to ration...
Source: In My Humble Opinion - November 25, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
Orthopaedic Board May Use Surgeon Scorecard in Certification Process
ProPublica has recently announced that the American Board of Orthopaedic Surgery, the board responsible for certifying orthopedic specialists, will use ProPublica’s Surgeon Scorecard to help assess the competency of its surgeons seeking recertification.
However, despite being reported on by ProPublica, the American Board of Orthopaedic Surgery has issued a statement: “To all diplomats and the orthopaedic community. You may have read certain information from an online publication, ProPublica. It should be known that the ABOS Board of Directors has not discussed nor considered the use of any ProPublica’s scorecar...
Source: Policy and Medicine - October 19, 2015 Category: American Health Authors: Policy and Medicine Writing Staff Source Type: blogs
