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Inactivity kills more than obesity: Let’s go beyond the headline

A new study about physical activity, obesity, and mortality has been propagating so many headlines and so much commentary, it’s pretty much a given that if you are seeing this, you have seen something like: “Inactivity kills more than obesity.” As is generally true in such cases, few of the people opining about the study seem to […]

We forget to ask patients what their goals are

Mr. Dwyer isn’t my patient, but today I’m covering for my partner in our family practice office, so he’s been slipped into my schedule. Reading his chart, I have an ominous feeling that this visit won’t be simple. A tall, lanky man with an air of quiet dignity, Mr. Dwyer is eighty-eight. His legs are […]

CMS: Millions of patients across the nation are benefiting from the - um - potential - of Health IT!

I presume this is, in part, a response to the Jan. 21 letter from AMA and the other medical societies as I wrote about two days ago at http://hcrenewal.blogspot.com/2015/01/meaningful-use-not-so-meaningul.html: CMS intends to modifyShow More Summary

Stop with the curbside consultations. They don’t help anyone.

Recently a friend of my husband’s in San Diego had a mammogram that showed some suspicious microcalcifications in her right breast.  She underwent a stereotactic biopsy which revealed ductal carcinoma in situ, the earliest form of breast cancer also known as stage 0 breast cancer.  This type of cancer is non-invasive and does not metastasize, […]

Flex Pharmaceuticals Is Testing What?

Flex Pharmaceuticals went public the other day, another in the string of IPOs in the biopharma world. This is also another Christopher Westphal company - he was a founder of Sirtris, about which much ink and many pixels (here and elsewhere) have been shed, and more recently founded Verastem (who also went public with alacrity). Show More Summary

Let’s be judicious in our use of surfactant

When babies are born prematurely, they often lack surfactant: a soapy substance produced in the lungs that helps to keep the air sacs open. Without surfactant, these tiny babies fight to breathe, a condition known as infant respiratory distress syndrome. Within the past 50 years, the delivery of artificial surfactant therapy has revolutionized neonatal care, saving […]

Hypertension management in stroke patient post discharge

From a new paper in Stroke: Background and Purpose—We examined blood pressure 1 year after stroke discharge and its association with treatment intensification... Results—Among 3153 patients with ischemic stroke, 38% had greater than or equal to 1 elevated outpatient SBP eligible for treatment intensification in the 1 year after stroke. Show More Summary

Expensive Placebos Work Better

The placebo effect weirds everyone out. I think we can say that without much fear of contradiction. It seems like magic, the fact that just thinking that you're getting some treatment of benefit can have actual benefits. Magic, though, it is not. Show More Summary

Doctors who attack other physicians

Her heart was failing; her ejection fraction was unmeasurable.  Her hip was broken, and she developed a pulmonary embolism post-operatively.  She was painfully close to death.  Yet at some point, the hospital finished and spit her out at the nursing home. She was confused. I tried to take the best history that I could.  Her […]

Parkinson's disease in the perioperative period: what the hospitalist needs to know

This review from the green journal contains a lot of pearls applicable not only to the perioperative situation but to hospitalization in general. From the abstract: Challenges in managing patients with Parkinson's disease in the perioperative...Show More Summary

You’re lucky to be a patient in America. Here are 3 reasons why.

As part of the increasing push for health care quality improvement, a lot of energy is being focused on improving our communication with patients and making sure that patient-centered care is more than just a buzz phrase. Gone are the days when the doctor-patient interaction was a wholly paternalistic one, where the doctor’s word was taken as […]

Top stories in health and medicine, January 29, 2015

From MedPage Today: U.S. Seniors Losing Grip on Muscle Strength. The first national survey on grip strength in older adults found that 5% of those over 60 had weak muscle strength, and 13% had intermediate strength. Low MI Risk in Patients With Non-MI Chest Pain. Patients treated in emergency departments (EDs) for chest pain not related […]

Review Of The Ongoing Post - Budget Controversy 29th January 2015. Utter Disarray!

Budget Night was on Tuesday 13th May, 2014 and the fuss has still not settled by a long shot. Indeed more than a few commentators are now wondering out loud if the Abbot Government will last for a second term.The modified Medicare co-payment...Show More Summary

A house call is worth a dozen tests. And then some.

Flossie Marks used to complain now and then about shortness of breath on exertion. She never had chest pain and, after all, she carried firewood from the basement to feed the wood stoves and fireplaces in her large Victorian house. At 81, who wouldn’t be a little short of breath doing that? Last summer, she […]

The ACS Becomes Invisible (But Not For Long)

Here's what looks like a weird publishing decision: the American Chemical Society seems to have blocked search engines for its publications. Try it: type "JACS" into Google, and you'll no longer get the journal's page showing up in the search results. Show More Summary

To the doctors who have lost patients. This is for you.

We all went into medicine to save lives. Deep within even the most cynical of us, is still that pre-med hopeful that believes we can and should restart each non-beating heart, make the non-breathing breathe and fill with blood those who’ve bled, filling them back with life. We expect that a patient’s condition will improve […]

Avoid the blame game during inpatient emergencies

Patients admitted to the hospital ward sometimes get sicker instead of getting better right away.  Often this can happen acutely. Depending on the circumstances, ranging from a “rapid response” for unstable vital signs to a cardiac arrest (a “code”), previously uninvolved hospital staff might be called on to help.  Despite the commotion, these events are […]

Cuckoo For Publishing Fees

The scam publishers line up, once again, to publish a manuscript full of gibberish. This one is titled "Cuckoo For Cocoa Puffs", and is authors, ostensibly, by Pinkerton LeBrain and Orson Welles. Seventeen "publishers" have acceptedShow More Summary

The Future of Diabetes Management: 8 Reasons Why We Face Extraordinary Times!

Around 400 million patients have diabetes worldwide according to estimations. And over the last few years, diabetes management has been improving but due to the new technologies and devices coming to the market very soon, the whole management of diabetes will significantly change in the coming years. Let me show you some examples how. Digital […]

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