Sirolimus for Polycystic Kidney Disease
New treatment options for polycystic kidney disease do not come along very often. The nature of the disease is such that treatment is inherently difficult as the pathophysiology is incompletely understood.
Despite that various methods are currently being investigated. One such is the drug sirolimus, which has been mentioned before. More recently however a pilot study performed in adult polycystic kidney disease patients has added further hope that sirolimus may one day be used routinely in this disease.
The effect of the drug sirolimus on development and growth of cysts was investigated over 6 consecutive months in 8 pa...
Source: All Kidney News - September 29, 2015 Category: Urology & Nephrology Authors: jadhavbca Tags: Kidney News FSGS TNF Source Type: blogs
As a physician, it is difficult to admit to a lack of control
“Why aren’t you treating this patient?”
Over the phone, the pediatrician’s voice crackled with disdain. I had just spent the last 5 minutes explaining why I didn’t think surgery was necessary for a patient whom the pediatrician had referred to me (unwillingly, as she pointed out during our conversation — the patient’s insurance wouldn’t cover visits to the much bigger competitor hospital that she normally referred to). I remembered the little girl we were discussing as I went through her chart. 2 years old and red-headed with freckles — typical characteristics for a child with high-grade ves...
Source: Kevin, M.D. - Medical Weblog - September 9, 2015 Category: Journals (General) Authors: Jeremy B. Wiygulis, MD Tags: Conditions Pediatrics Surgery Source Type: blogs
Shanda’s life and health turnaround on the Wheat Belly lifestyle
Shanda shared her impressive experience living the Wheat Belly lifestyle:
“I am in shock right now. I just found a picture of me before starting my journey in 2012. You gave me my life back.
“I used to have IBS symptoms, UTI [urinary tract infection] symptoms (with no infection), debilitating lower abdominal pains that no doctor could ever figure out. I was taking massive amounts of pain killers. My anxiety got to the point of panic attacks (I felt like I couldn’t breathe). I had chronic depression that I had since childhood. I also had horrible PMS problems, and absolutely no energy to do anything. To t...
Source: Wheat Belly Blog - August 31, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories abdominal pain IBS Inflammation irritable bowel panic attacks pms premenstrual Weight Loss Source Type: blogs
Uquora – Hope, Hype and Maybe a Case of Diarrhea
Before you go out and spend $25 for 10 packets of Uquora, the new after-sex UTI prevention drink that launched today, you should consider if it actually works.
What’s in Uqora?
Uqora’s main active ingredient is D-Mannose (2 gm), combined with Vitamin C (600 mg), Vitamin B6, Calcium and Magnesium. (The company website does not list amounts for the last three ingredients.) The ingredients are made into a powder that you mix with water and drink.
The manufacturer claims that Uqora will reduce the chance of getting a UTI if you drink it after having sex, after exercise or during travel, all activities linked to re...
Source: The Blog That Ate Manhattan - August 20, 2015 Category: Primary Care Authors: Margaret Polaneczky, MD Tags: Women's Health Post-coital Post-sex PRevention Uqora urinary tract infection UTI Source Type: blogs
The Unintended Consequences of Public Reporting
ProPublica Surgeon Scorecard Ad
A major concern surrounding ProPublica’s recently released “Surgeon Scorecard” is that rating physicians in a public database solely on complication rates may discourage surgeons from operating on high-risk patients. The fear, it turns out, is a legitimate one. A study published this month in the Journal of the American College of Cardiology examined the effect that public reporting of procedural outcomes has on heart attack patients. The authors looked at two states, Massachusetts and New York, which mandate the public reporting of hospital outcomes of per...
Source: Policy and Medicine - August 12, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
The Struggle to Find Truth from a Position of Ignorance
Today I stumbled over a popular press article on the topic of longevity science, in which a fair amount of attention is given to Aubrey de Grey and the SENS Research Foundation vision for rejuvenation biotechnology. Like most such articles it is a view from an individual who, though a scientist himself, stands far outside the field of aging research - just like much of the world he is looking in with limited knowledge, trying to make sense of it all, in search of truth from a position of ignorance.
This struggle, the search for truth in a field in which you will never personally know enough to verify any significant detai...
Source: Fight Aging! - July 30, 2015 Category: Research Authors: Reason Tags: Of Interest Source Type: blogs
Reducing Practice Variation At Crystal Run Healthcare
Research has shown wide variation in per capita spending among different states and among different counties within the same state. Some of this variation can be explained by the health status of the population, local pricing, patient cultural and demographic factors, and the local liability environment.
However, the vast majority of variation in spending is unexplained and likely due to a failure of health care providers to follow established best practice guidelines. This type of variation is associated with unnecessary over-utilization, while reducing variation leads to reductions in utilization and improvements in qua...
Source: Health Affairs Blog - July 23, 2015 Category: Health Management Authors: Scott Hines, Jonathan Nasser and Linda Green Tags: Costs and Spending Equity and Disparities Health Professionals Innovations in Care Delivery Medicaid and CHIP Medicare Organization and Delivery Population Health Quality ACOs chronic conditions Crystal Run Healthcare NCQA Physic Source Type: blogs
Please, can this patient be just a little more sick?
I take a deep breath as I get ready to go see Mrs. H. I can predict after sign-out from the ER doc where this is likely to go. Mrs. H. is an 87-year-old woman who comes to the emergency room with weakness. She stumbled and fell to the floor but could not get up to reach the phone to call for help. She laid there on the floor for an hour until her son stopped by to visit and brought her to the ER.
Through diligent testing, she is found to have a urinary tract infection and dehydration. She has a few bruises, but nothing is broken. Her son is with her in the emergency department, and he is relieved that she will be admitted ...
Source: Kevin, M.D. - Medical Weblog - July 12, 2015 Category: Journals (General) Authors: Brett Hendel-Paterson, MD Tags: Physician Geriatrics Hospital Hospitalist Source Type: blogs
When it comes to poop, doctors don’t know sh*t
It all started with a routine fecal transplant.
The case report was published earlier this year: a thirty-two-year-old female suffering from Clostridium difficile colitis resistant to multiple rounds of antibiotics was given a fecal transplant and quickly recovered from the debilitating bouts of diarrhea and abdominal pain that had plagued her for months.
That wasn’t what made headlines, though. Using fecal transplants to treat resistant cases of C. diff. colitis has been around for years. The procedure, which involves administering fecal matter from a donor to a patient via colonoscopy, endoscopy, or enema, is meant to ...
Source: Kevin, M.D. - Medical Weblog - June 22, 2015 Category: Journals (General) Authors: Alberto Hazan, MD and Anthony Carrozza, MD Tags: Conditions GI Source Type: blogs
Arkansas Payment Improvement Initiative: Expanding Episodes To Other Clinical Areas
Editor’s note: This post is part of a periodic Health Affairs Blog series, looking at payment and delivery reforms in Arkansas and Oregon. The posts are based on evaluations of these reforms performed with the support of the Robert Wood Johnson Foundation. The authors of this post are part of the team evaluating the Arkansas model.
After the first year of implementation of the episodic payment component of the multi-payer Arkansas Payment Improvement Initiative (APII), the state has identified both successes and challenges. While previous posts go into greater detail on the nuances of Arkansas’ approach to episodes and...
Source: Health Affairs Blog - May 19, 2015 Category: Health Management Authors: William Golden, Joseph W. Thompson, Michael Motley, A. Mark Fendrick, Christopher Mathis and Michael Chernew Tags: Innovations in Care Delivery Medicaid and CHIP Payment Policy APII Arkansas Payment Improvement Initiative CMMI CMS Payment Reform PCMH SIM Testing Award States Source Type: blogs
LITFL Review 182
Welcome to the 182nd LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.The Most Fair Dinkum Ripper Beauts of the Week Essentials of Emergency Medicine is offering a US resident scholarship in partnership with ALiEM and EMCrit for the October Essentials course in Las Vegas. Check it out and apply now! [AS] The Best of #FOAMed Emergency MedicineGreat pearl from ...
Source: Life in the Fast Lane - May 17, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Successful Acute Care Payment Reform Requires Working With The Emergency Department
Note: The work reflected in this post and our May 6th MEDTalk, “Reimagining Emergency Medicine: Moving to Integrated Care for the Ill and Injured," is made possible through the Merkin Initiative on Physician Payment Reform and Clinical Leadership, a Brookings Institution project to engage clinicians in health care delivery and financing reform. The May 6 event will bring together practicing emergency physicians and leaders from health insurers, Medicare, and health care organizations to discuss the future of the acute care system.
More than a third of all patient encounters in the United States---354 million per year-...
Source: Health Affairs Blog - May 5, 2015 Category: Health Management Authors: Jesse Pines Tags: Costs and Spending Featured Hospitals Innovations in Care Delivery Organization and Delivery Payment Policy Quality Alternative Payment Methodology Chesapeake Regional Information System for our Patients Emergency Medicine ER For Emerg Source Type: blogs
More from the Grantmakers In Health Annual Conference: Diane Meier on Palliative Care; a Film on Elder Care
This past week, I gave you a brief glimpse of the 2015 GIH Annual Conference in Austin, Texas.
Here are two more vignettes from the conference, held in March. Its theme was Pathways to Health.
Diane Meier
Director of the Center to Advance Palliative Care at the Icahn School of Medicine at Mount Sinai and a past MacArthur Fellow (2008), Diane Meier was another plenary speaker. She commented to the audience of mostly foundation staffers that her body of work and career in palliative care is due to the support of private-sector philanthropy, including more than twenty foundations.
Following are just some of the points she...
Source: Health Affairs Blog - April 23, 2015 Category: Health Management Authors: Lee-Lee Prina Tags: Costs and Spending GrantWatch Health Professionals Hospitals Long-term Services and Supports Quality Aging Health Care Delivery Health Philanthropy Home Health Palliative Care Physicians Workforce Source Type: blogs
Public Citizen Urges FDA To Penalize Drug Makers Over Diabetes Ads, Criticizes the Agency’s “Dismal Record” on Issuing Warning Letters
Consumer advocacy group Public Citizen is calling on the Food and Drug Administration (FDA) to “stop the apparently violative off-label promotional statements” in various Type 2 Diabetes advertisements, which the group argues are being advertised as weight-loss drugs. “[N]one of the drugs is approved for weight loss and, despite the presence of disclaimers that the medications are not weight-loss drugs, the implication is clearly that weight loss is an additional potential benefit of the drugs,” Public Citizen states.
This request comes in the midst of a “drastic reduction” in the past few years of direct-to-co...
Source: Policy and Medicine - April 3, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Losses and Gains
Loss is something all humans face in their everyday lives. As a physician, the effects are often magnified. People die, they move away, they graduate from your services, or occasionally they pursue care elsewhere. Parting can sometimes bring relief, and others a deep sense of failure. But with Clara, I'm not sure we actually parted. Mostly, I was left with confusion.Clara came to me by way of the nursing home. Her family had brought her to the hospital when she became too weak to rise out of the reclining chair in her living room. The hospital stay was short. Multiple diagnos...
Source: In My Humble Opinion - February 9, 2015 Category: Primary Care Authors: Jordan Grumet Source Type: blogs
