KevinMD.com

Bacterial resistance to chronic antibiotics, and why it’s a problem

Conditions and Diseases

August 4, 2010

Unlike climate change, where there’s a large contingent of denialists who spread doubt about the scientific evidence, no one denies that antibiotic resistance is a problem. There is controversy, however, on the question of just how much the widespread use of antibiotics contributes to the problem.

The mechanism is not in dispute: If you expose bacteria to antibiotics, they will mutate to become resistant. But “overuse” of antibiotics is not the …

Minimize patient waiting after a potential cancer diagnosis

Howard Luks, MD

Conditions and Diseases

August 4, 2010

I received a very troubling phone call from a close friend recently. He underwent a study, at the age of 40, and the physician came out of the procedure and said, “you have a large tumor, do you want me to call a surgeon for you.”

The purpose of this post is not to comment on the physician’s behavior or delivery techniques, but to define this very precarious and anxiety producing …

Obesity in American children and adults continues to grow

Emily P. Walker

Conditions and Diseases

August 4, 2010

by Emily P. Walker

The number of obese adults in the U.S. continues to rise, despite a growing number of federal anti-obesity initiatives in the past two years, according to a new report.

The seventh annual “F as in Fat” report, released Tuesday by the nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation, found that obesity rates continued to rise in 28 states from 2007 through 2009.

Nationally, two-thirds of …

Breathe properly at night and learn to sleep better

Steven Y. Park, MD

Conditions and Diseases

August 4, 2010

Every time you see a depiction of someone sleeping on TV or in the movies, you’ll see the person sleeping on his or her back, and oftentimes, snoring.

The lay public, doctors, and even alternative and complementary practitioners naturally assume that you’re able to breathe properly at night. This couldn’t be further from the truth.

Evolutionary biologists and comparative anatomists have stated that speech and language development was ultimately detrimental to humans. …

Android and iPhone pros and cons for healthcare

Kevin

Health Technology

August 4, 2010

by Jeff Brandt

I wrote an article for KevinMD.com several months ago discussing the benefits of Android for the healthcare market. I also compared Android with the iPhone. I listed the iPhone’s technical shortcomings and really angered the “believers of all things Apple”. That was not my intent.

Apple’s latest release of iPhone 4.0 and their new operating system (OS) 4.0 corrects many of …

How to say goodbye to patients

Christian Sinclair, MD

Patient

August 3, 2010

OncRN is a wonderful blog written by an anonymous author sharing stories and insights in her line of work that many times speak to palliative themes. S/he says it best in her blog description,

my life gets intermittantly (sic) rocked by the wonders/horrors of being an oncology nurse. i just need to talk it all through sometimes.

A recent post is about how to say good-bye to our patients, particularly …

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How to say goodbye to patients

Unread echocardiogram fallout at Harlem Hospital Center

Larry Husten, PhD

Conditions and Diseases

August 3, 2010

Recently, the New York Times reported that Harlem Hospital Center had finally completed its investigation into thousands of echocardiograms that after receiving an initial reading by a technician had never been read by a physician.

It turns out that out of 7,000 tests that went unread, only 14 patients “might have been misdiagnosed because their tests had not been handled properly,” according to the hospital spokeswoman quoted in the story. …

Create a family practice mystique in medical school

Skeptical Scalpel, MD

Physician

August 3, 2010

For at least the last 20 years, graduates of U.S. medical schools have resisted pleas from organized and disorganized medicine to become primary care physicians (PCPs). Since there is already a severe shortage of PCPs, pundits are wondering who is going to take care of the hordes of newly insured by 2014. Many have speculated about the possible reasons for this dilemma such as the relatively paltry earning potential of …

Was JUPITER trial data influenced by AstraZeneca to favor Crestor?

Charles Bankhead

Medications

August 3, 2010

by Charles Bankhead

Reanalysis of a landmark cholesterol-lowering trial of people typically considered at low risk for heart attacks indicated that the results are flawed — and do not support the primary-prevention benefits that made headlines, authors of the review asserted.

The reanalysis of the massive JUPITER trial involving almost 18,000 people with low or normal cholesterol but elevated levels of the inflammatory biomarker C-reactive protein (CRP) — turned up no evidence …

Medications that increase the risk of photosensitivity

Kevin

Medications

August 3, 2010

by Marianna Rakovitsky, RPh

Oh, Summer! The weather is warm, the sun is shining and it is the time when we try to get outside as much as possible. Summer is my favorite time of the year. I love the beach, days that are filled with light and sunshine, trips to the orchards and hanging out in the backyard. The sunshine that makes the summer such a …

Is patient adherence responsible for health quality and safety?

Steve Wilkins, MPH

Patient

August 3, 2010

A while back I did in a post where I asked the question, What can patients really expect from their physicians today? In that post, I wondered at the fact that many patients still have a high degree of trust in their physician in spite of the quality and safety problems attributed to physicians in the press.

For example:

On average, US adults receive only 50% of recommended …
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Is patient adherence responsible for health quality and safety?

Every patient deserves a death with dignity and without pain

George Lundberg, MD

Physician

August 3, 2010

Death is not the enemy. We all die.

The enemies of patients and physicians are premature death, disease, disability, pain, human suffering.

I believe that all people deserve a death with dignity and without pain. Palliative care is the right mode for as many as 80% of all Americans who will die of chronic progressive incurable diseases. Eighty percent of those state that they do not want to die in a hospital …

Pay specialists less to save primary care

Edward Pullen, MD

Health Policy

August 2, 2010

Since 1997 the number of US medical students choosing to go into primary care has decreased by more than 50%.

It seems that sources as diverse as the Obama Administration and the Wall Street Journal think that we should find a way to encourage medical students to choose primary care specialties in order to allow Americans to have the best and most cost effective care. This is very problematic when primary …

The difficulty of regulating x-ray radiation in the ER

WhiteCoat, MD

Conditions and Diseases

August 2, 2010

A recent article in the New England Journal of Medicine touched off another salvo about how non-clinicians have no problems judging the abilities of clinicians in the world of medicine.

The article begins by presenting the case of a woman who awoke with facial paralysis and then went to the emergency department. On arrival, she received CT scans and MRI scans of her brain. When those were normal, she was diagnosed …

Caring for dying patients needs better physician communication

MedPage Today

Patient

August 2, 2010

by Michael Smith

Clinicians treating dying patients did well in managing pain but fell short on communicating with patients and their loved ones, researchers said.

The findings, from a single-institution study, suggest that those who care for terminal patients also often failed to assess shortness of breath in a dying patient whose mechanical ventilation was withdrawn, according to Anne Walling, MD, of the University of California Los Angeles, and colleagues.

But overall those …

Doctors hiring scribes because of electronic medical records

Douglas Perednia, MD

Health Technology

August 2, 2010

I was visiting with my physician colleague Debbie the other day, which is always a pleasure. She is, by far, one of the best dermatologists I know. She had purchased an electronic medical record (EMR or EHR) a year or two ago and I asked her how it was going.

“Pretty well,” she said, “but I’ve had to start using a scribe. It’s just too inefficient any other way. I was …

What does a TIA feel like? A Stroke Diaries excerpt

Kevin

Patient

August 2, 2010

An excerpt from Stroke Diaries.

by Olajide Williams, MD

The man who did not take his medicine

Pedro was lying on the bathroom floor next to the toilet bowl. Water was still running from rusty faucet, overflowing the sink, and pooling around his body as he lay limp on wet porcelain tiles. Lucy was standing over him and whining. The young black Labrador retriever had not left …

How healthcare reform affects women

MedPage Today

Health Policy

August 2, 2010

by Joyce Frieden

An estimated 30 million women will be helped by the new health reform law over the next 10 years, according to a report from The Commonwealth Fund.

“While women are just as likely as men to be uninsured, they are more likely [than men] to have trouble buying coverage on the individual market,” Karen Davis, PhD, president of the fund, said in a teleconference announcing the report’s release. “This …

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How healthcare reform affects women

How adult smoking affects behavior in children

MedPage Today

Conditions and Diseases

August 1, 2010

by Nancy Walsh

Both maternal and paternal cigarette smoking can contribute to adverse chronic conditions — physical and psychological — in children, two large studies found.

Writing in the July issue of Pediatrics, Marie-Jo Brion, PhD, of the University of Bristol in England, and colleagues reported that children in two cohorts whose mothers smoked were more likely to have conduct/externalizing behavior problems than were those who had no prenatal tobacco exposure:

* British …

Empathy is needed for better relationships with patients

John Schumann, MD

Patient

August 1, 2010

Most people enter the healing arts with a genuine desire to serve others.

The long educational journey and the realities of both the workaday world and the various business models of health care often strain our abilities to act in an empathic manner.

We have to pay the bills, after all.

“No money, no mission,” is a refrain I’ve often heard in the non-profit corners of the health care world, justifying business decisions …