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Cardiologists discuss how far myocardial infarction management has come

Kevin

Medications

January 10, 2010

Originally published in MedPage Today

by Peggy Peck, MedPage Today Executive Editor

“What we did for patients with acute MI was place them in a cool, dark place. Give them morphine for pain and lidocaine to prevent arrhythmias and hope for the best.”

The speaker is Steven Nissen, MD, director of Cardiovascular Medicine at the Cleveland Clinic. He is describing standard care 25 …

Is erectile dysfunction associated with restless leg syndrome?

Kevin

Conditions and Diseases

January 9, 2010

Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

Men with restless leg syndrome (RLS) had a significantly increased risk of erectile dysfunction compared with men who did not have the neurologic disorder, data from a large cohort study showed.

The likelihood of erectile dysfunction increased with the frequency of restless leg episodes, reaching an adjusted risk apex about …

Op-ed: Ways to make primary care the key to health reform

Kevin

Health Policy

January 9, 2010

The following op-ed, co-written with Rahul Parikh, was published on December 16th, 2009 in CNN.com.

America is closer to meaningful health care reform than at any time in its history. As we have all witnessed, finding a way to both provide every American access to affordable health care while seeking to control health care costs has not been easy.

Many of the proposed solutions have led to sharp disagreements, with contention …

How a psychiatrist can write 100,000 prescriptions a year, and what that means for primary care

Matthew Mintz, MD

Physician

January 8, 2010

The Miami Herald is reporting an investigation of a psychiatrist who wrote almost 100,000 prescriptions a year. Sen. Grassley and the feds have halted payment to this Miami psychiatrist who stated that “he prescribes only what is medically necessary” and “works long hours, seeing patients for 10 minutes at a time and many of his patients need four or five medications.”

I have no personal knowledge, interaction, acquaintance with psychiatrist Dr. …

How similar is pandemic H1N1 influenza to the seasonal flu?

Kevin

Conditions and Diseases

January 8, 2010

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Pandemic H1N1 influenza behaved much like seasonal and previous pandemic flu viruses in an early, isolated outbreak at a New York City high school, researchers found.

Natural history and transmissibility characteristics were similar in an April outbreak that sickened about 800 students and staff members, according to Justin Lessler, PhD, …

Linking the USPSTF mammogram guidelines to their virtual colonoscopy recommendations

Kevin

Conditions and Diseases

January 7, 2010

by Mark E. Klein, MD

“I think anytime you use science to kind of fundamentally change what people are used to, I think it’s a difficult thing to grapple with.” So spoke Ned Calonge, chair of the United States Preventive Services Task Force (USPSTF) in explaining the reaction to that group’s recommendation to radically alter their previous guidelines for breast cancer screening. Regrettably the incorrect application of science, as in …

Doctors owe their patients some fiduciary responsibility

Kevin

Physician

January 7, 2010

Originally published in HCPLive.com

by Jeff Brown, MD

Fiduciary responsibility is the obligation for people entrusted with financial affairs to act in their client’s best interest, theoretically being both transparent in their dealings and accountable for them. Typically, this applies to CPAs, lawyers, financial advisers and the like. Would that it were also true for our legislators, but that’s a story for another day. To the point, physicians do not usually think …

How effective is CA 125 and other biomarkers to screen for ovarian cancer?

Kevin

Conditions and Diseases

January 7, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Rising blood levels of several biomarkers show the presence of ovarian cancer — just not early enough.

That’s the conclusion of a retrospective longitudinal case-control study of levels of half a dozen proteins linked to the disease, according to Garnet Anderson, PhD, of the Fred Hutchinson Cancer Research Center in …

The story behind a whistleblower doctor license reinstatement hearing

David K. Cundiff, MD

Physician

January 6, 2010

After the LA County + USC Medical Center closed my Pain and Palliative Care Service because of budget cuts in 1995, I spoke out publicly about the dysfunctional financial reimbursement system funding charity care in LA County.

For example, when my consultation service controlled the pain and distressing symptoms of over 400 terminally ill cancer and AIDS patients per year and discharged them to home hospice programs, the hospital lost about …

Despite no cure, progress in the treatment of HIV/AIDS

Kevin

Conditions and Diseases

January 6, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

It’s 1984. A 20-year-old homosexual man walks into the clinic complaining of swollen glands.

It could well be a death sentence.

It is only three years since the first handful of cases of what would come to be known as acquired immune deficiency syndrome (AIDS) were described. Little is known about …

Public hospitals are the unsung jewels of our healthcare system

Danielle Ofri, MD, PhD

Physician

January 5, 2010

Public hospitals have a bad rap. They’re viewed by many as hospitals of last resort, and most patients with private insurance do anything to avoid them.

As a long-time physician in a public hospital, I’m sensitive to this reputation. I wouldn’t work in my hospital if I didn’t feel that it delivered excellent health care. I’m certainly aware that private hospitals have amenities that public hospitals can’t afford, but many of …

Will physician and hospital penalties improve patient care?

Kevin

Health Policy

January 5, 2010

Originally published in HCPLive.com

by Alan Berkenwald, MD

In 1904, the Scottish author Sir James Matthew Barrie sent Peter Pan off to Never-Never Land to escape growing up and to enjoy many-many adventures. As children, we all hoped it really existed. In truth, many of us fantasized, one day, to make the trip ourselves.

Well, good news for physicians – that day has arrived!

How patients are dying from H1N1 infection

Kevin

Conditions and Diseases

January 5, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Brazilian researchers have found three distinct patterns of lung damage in patients who died of the H1N1 pandemic flu.

They also found evidence of a so-called “cytokine storm,” a runaway immune response associated with the lung damage, according to Thais Mauad, MD, PhD, of Sao Paulo University Medical School, …

How can medical guidelines be immune from politics?

Marya Zilberberg, MD, MPH

Conditions and Diseases

January 4, 2010

The recent uproar over the new screening mammography recommendations got me thinking about a lot of stuff. One of the lessons cited by some journalists and pundits is on how potentially volatile information should be presented to the public. The USPSTF was excoriated by critics not only for what it said, but how it said it. While the objections over the former can be dismissed as ravings of loud and …

What’s the most popular way to diagnose a pulmonary embolism?

Kevin

Conditions and Diseases

January 4, 2010

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Emergency physicians and radiologists overwhelmingly choose computed tomography (CT) imaging to diagnose pulmonary embolism, a potentially deadly blockage of lung arteries, a new study found.

Ninety percent of radiologists and 96% of emergency physicians use CT as their first-line choice for the diagnosis of pulmonary embolism, according to a report …

How women can benefit from oral contraceptive pills

Kevin

Medications

December 31, 2009

Originally posted in MedPage Today

by Nancy Walsh, MedPage Today Contributing Writer

Hormonal contraceptives have a variety of noncontraceptive uses, ranging from common problems such as dysmenorrhea to severe conditions such as premenstrual dysphoric disorder, according to a new practice bulletin from the American College of Obstetricians and Gynecologists (ACOG).

“Combined hormonal contraceptives can correct menstrual irregularities resulting from oligo-ovulation or anovulation and …

How to tell a family that their loved one has died

Kevin

Patient

December 30, 2009

by Tim Noonan

When a team misses out on an opportunity to go to the Super Bowl, World Series, Final Four, or something similarly trivial, these words may be appropriate. When the person, who has been the center of your life dies, what is more insensitive than, We’re sorry for your loss?

What kind of language is that to use when providing some of the worst news we could imagine? True, we …

Why are women refusing an MRI to screen for breast cancer?

Kevin

Conditions and Diseases

December 30, 2009

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Many women at elevated breast cancer risk may refuse MRI as part of their screening program, largely because of fear and inconvenience, researchers found.

Among eligible women with dense breasts who were at intermediate to high risk for breast cancer, 42.1% refused additional MRI screening as part of a …

How to find the best cancer specialist for you

Kevin

Conditions and Diseases

December 29, 2009

by Dana Griffen

Receiving a cancer diagnosis is an upsetting experience for the patient, as well as his or her family and friends. Cancer patients are thrust into a new world with new language and new rules. Knowing where to turn and who you can trust is a huge concern.

One of the first things a cancer patient will discover is that he or she will not be treated by only one …

A cockpit checklist to improve patient safety

Kevin

Physician

December 29, 2009

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Medical teams should take a lesson from airplane crews, a new study concludes.

Medical personnel who used procedural checklists modeled after preflight checklists used by airplane crews were more likely to report safety-related incidents and feel empowered to address safety issues, according to an online report in the Dec. 21 …

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