Hospital medicine

5,188 articles · Since 2004

Articles, page 149

How teamwork is essential in the emergency department

November 12, 2009Nov 12, 20094

I recently cared for a patient who raised my heart-rate a bit. Of course, any emergency physician will tell you, the potentially difficult and complicated cases often come at the end of the shift, as you’re trying to clean up all of the paperwork and ‘head for the house.’ Nurse Ginger came to me and said, ‘we need a doctor in room 11.’ I snarled, snatched the paper, grumped and …

Conditions and diseases

Many women report nerve-related persistent pain after breast surgery

Kevin

November 12, 2009Nov 12, 2009

Originally published in Insidermedicine Nearly half of women who undergo surgery and other treatments for breast cancer report having persistent pain in and around the treatment area a year or more later, probably because of nerve damage, according to research…

Originally published in Insidermedicine

Nearly half of women who undergo surgery and other treatments for breast cancer report having persistent pain in and around the treatment area a year or more later, probably because of nerve damage, according to research published in the November 10 issue of the Journal of the American Medical Association.

Here is some information about neuropathic, or nerve, pain:

• It is a type of pain that occurs when …

Conditions and diseases

Will video cameras in the OR decrease the rate of wrong-site surgery?

MedPage Today

November 12, 2009Nov 12, 20096

by Kristina Fiore, MedPage Today Staff Writer Rhode Island Hospital, located in Providence, will pay $150,000 and install video cameras in all of its operating rooms after performing its fifth wrong-site surgery since 2007, according to the state's Department of…

by Kristina Fiore, MedPage Today Staff Writer

Rhode Island Hospital, located in Providence, will pay $150,000 and install video cameras in all of its operating rooms after performing its fifth wrong-site surgery since 2007, according to the state’s Department of Health.

The hospital will also have to open its ORs to an inspector who will observe surgical procedures and protocols for at …

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Conditions and diseases

How do people with dementia die?

Victor G. Dostrow, MD

November 11, 2009Nov 11, 20093

Originally published in HCPLive.com by Victor G. Dostrow, MD Dementia is a terminal illness. However, people with advanced dementias often languish in skilled nursing facilities, far from the ministrations of specialists. And, with reasonable luck, they have directives that specify…

Originally published in HCPLive.com

by Victor G. Dostrow, MD

Dementia is a terminal illness. However, people with advanced dementias often languish in skilled nursing facilities, far from the ministrations of specialists. And, with reasonable luck, they have directives that specify that they are not to be taken to the hospital in the event of a respiratory arrest. Consequently, most of us are not privy to the mechanisms of demise in such situations. …

Read more…

How do people with dementia die?

Conditions and diseases

Do home fetal heart monitors give mothers false reassurance?

MedPage Today

November 10, 2009Nov 10, 20092

Originally published in MedPage Today by Kristina Fiore, MedPage Today Staff Writer Expectant mothers may enjoy listening to their unborn babies' heartbeats, but they shouldn't rely on home fetal heart monitors to provide an accurate picture of fetal health, researchers…

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Expectant mothers may enjoy listening to their unborn babies’ heartbeats, but they shouldn’t rely on home fetal heart monitors to provide an accurate picture of fetal health, researchers say.

The devices may provide false reassurance in some situations, according to Abhijoy Chakladar, MD, of Princess Royal Hospital in West Sussex, …

Conditions and diseases

Clostridium difficile infection is spreading from the hospital to the community

MedPage Today

November 5, 2009Nov 5, 2009

Originally published in MedPage Today by Charles Bankhead, MedPage Today Staff Writer Clostridium difficile infection has spread from the hospital to the community but has proved manageable thus far. From 1991 to 2005, the incidence of community-acquired C. difficile in…

Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

Clostridium difficile infection has spread from the hospital to the community but has proved manageable thus far.

From 1991 to 2005, the incidence of community-acquired C. difficile in Olmsted County, Minn., quadrupled but still remained less common than the hospital-acquired gastrointestinal infection, Sahil Khanna, MD, of the Mayo Clinic in …

Physician voices

Who’s most likely to spread infection in the hospital?

MedPage Today

November 2, 2009Nov 2, 2009

Originally published in MedPage Today by Michael Smith, MedPage Today North American Correspondent Good hand hygiene among healthcare workers is an important factor in preventing the spread of disease, but exactly how important depends on an individual's job, researchers said.…

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Good hand hygiene among healthcare workers is an important factor in preventing the spread of disease, but exactly how important depends on an individual’s job, researchers said.

In a mathematical model, so-called “peripatetic” workers — such as therapists or radiologists — were most likely to spread pathogens if they …

Health policy

Is the impending physician shortage worse than we thought?

MedPage Today

October 31, 2009Oct 31, 200914

Originally published in MedPage Today by Charles Bankhead, MedPage Today Staff Writer The physician workforce in the U.S. is growing smaller and younger, according to data from the Census Bureau, but conflicting estimates make it difficult to determine just how…

Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

The physician workforce in the U.S. is growing smaller and younger, according to data from the Census Bureau, but conflicting estimates make it difficult to determine just how many doctors are out there — and how many the nation will need.

The census survey showed 67,000 fewer physicians than estimates based …

Health policy

Discussing end-of-life care in the ICU and saving Medicare money

Marya Zilberberg, MD, MPH

October 25, 2009Oct 25, 20097

I think by now there is not a person in the US who cannot quote at least approximately how much we spend annually on healthcare. Fewer people appreciate that nearly 1/3 of this $2.2 trillion bill is eaten by hospitalizations, amounting to about $680 billion. Although the data in the diagram below represent a single year, the overall distribution of expenses is remarkably constant over time. …

Health policy

When compassion meets progress in American health care

Edwin Leap, MD

October 24, 2009Oct 24, 20094

Does anyone realize that the chaos of modern American health-care is not a tragedy, but a triumph? We’re so busy trying to fix what isn’t broken and ignoring what is, so busy casting stones and casting doubts that we are…

I have practiced medicine in this labyrinth for 16 years. I am an emergency physician. I practice in what may be considered the ‘epicenter’ of modern …

Conditions and diseases

When patients receive too much radiation from CT scans by mistake

MedPage Today

October 21, 2009Oct 21, 2009

Originally published in MedPage Today by Crystal Phend, MedPage Today Senior Staff Writer Reports of stroke patients who were accidentally exposed to eight times the normal radiation dose during diagnostic CT scans at Cedars-Sinai Medical Center in Los Angeles are…

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Reports of stroke patients who were accidentally exposed to eight times the normal radiation dose during diagnostic CT scans at Cedars-Sinai Medical Center in Los Angeles are prompting safety warnings and soul searching among radiologists nationwide.

Over an 18-month period, 206 patients at the center received 3 to 4 …

Conditions and diseases

Does robotic surgery for prostate cancer help patients?

MedPage Today

October 19, 2009Oct 19, 20092

Originally published in MedPage Today by Peggy Peck, MedPage Today Executive Editor Men who opt for minimally invasive prostate surgery -- often with a helping hand from a robot -- are twice as likely to have genitourinary complications as men…

Originally published in MedPage Today

by Peggy Peck, MedPage Today Executive Editor

Men who opt for minimally invasive prostate surgery — often with a helping hand from a robot — are twice as likely to have genitourinary complications as men who have a traditional prostatectomy.

That finding is especially troubling because the use of robotic-assisted minimally invasive prostatectomy has increased exponentially in …

Conditions and diseases

Op-ed: Reasons why health care workers need to receive the H1N1 flu vaccine

Kevin Pho, MD

October 18, 2009Oct 18, 20092

The following op-ed was published on October 5th, 2009 in The New York Times’ Room for Debate blog. Not only are patients asking me whether they should receive the H1N1 influenza vaccine, but it’s a question doctors are asking themselves.…

The following op-ed was published on October 5th, 2009 in The New York Times’ Room for Debate blog.

Not only are patients asking me whether they should receive the H1N1 influenza vaccine, but it’s a question doctors are asking themselves.

Recent polls say doctors and nurses may be more resistant to getting vaccinated than most Americans. The British Medical Journal published a survey showing that less than half of health care …

Health policy

Doctors need to fix the health care system that they had a hand in breaking

Daniel A. Graubert, MD

October 16, 2009Oct 16, 20097

by Daniel A. Graubert, MD Medicine has changed so dramatically since I graduated medical school in the 1980's, that it is hardly recognizable. Certainly, there has been an enormous growth in knowledge which is often beneficial, but has often led…

by Daniel A. Graubert, MD

Medicine has changed so dramatically since I graduated medical school in the 1980’s, that it is hardly recognizable.

Certainly, there has been an enormous growth in knowledge which is often beneficial, but has often led us down the wrong path. For example, when advanced imaging techniques such as CT scans and MRIs became available, we were able to see the inside of large numbers of patients …

Conditions and diseases

Texting young liver transplant patients to take their medications

MedPage Today

October 16, 2009Oct 16, 2009

Originally published in MedPage Today by Todd Neale, MedPage Today Staff Writer Here's a case where texting may actually improve a teenager's health: Text message reminders appear to be effective in getting young liver transplant patients to take their immunosuppressive…

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Here’s a case where texting may actually improve a teenager’s health: Text message reminders appear to be effective in getting young liver transplant patients to take their immunosuppressive medications, a small study showed.

In 41 patients with a median age of 15, there was a significant improvement in medication compliance …

Conditions and diseases

One way to treat patients with severe H1N1 flu

MedPage Today

October 15, 2009Oct 15, 2009

Originally published in MedPage Today by Todd Neale, MedPage Today Staff Writer Most patients who underwent extracorporeal membrane oxygenation (ECMO) for respiratory failure survived their struggle with pandemic H1N1 flu, according to a study by researchers from Australia and New…

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Most patients who underwent extracorporeal membrane oxygenation (ECMO) for respiratory failure survived their struggle with pandemic H1N1 flu, according to a study by researchers from Australia and New Zealand.

Of the 68 patients treated with ECMO during the Southern Hemisphere’s winter, 54 were still alive as of Sept. 7, according to …

Conditions and diseases

How H1N1 pandemic flu will affect intensive care units

MedPage Today

October 14, 2009Oct 14, 2009

Originally published in MedPage Today by Michael Smith, MedPage Today North American Correspondent The winter wave of the pandemic H1N1 flu hit intensive care units in Australia and New Zealand hard, researchers said, and may offer lessons for doctors bracing…

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

The winter wave of the pandemic H1N1 flu hit intensive care units in Australia and New Zealand hard, researchers said, and may offer lessons for doctors bracing for the pandemic’s return to the Northern Hemisphere.

All told, 722 people with confirmed pandemic flu were admitted to one of the …

Physician voices

Do HMOs drive blacks to the emergency room?

MedPage Today

October 13, 2009Oct 13, 20092

Originally published in MedPage Today by John Gever, MedPage Today Senior Editor Many African-Americans in California enrolled in health maintenance organizations (HMOs) appear to prefer getting medical treatment in emergency rooms, researchers said. One-quarter of African-Americans enrolled in Kaiser Permanente…

Originally published in MedPage Today

by John Gever, MedPage Today Senior Editor

Many African-Americans in California enrolled in health maintenance organizations (HMOs) appear to prefer getting medical treatment in emergency rooms, researchers said.

One-quarter of African-Americans enrolled in Kaiser Permanente or other commercial HMOs in California, who would therefore have a range of treatment options, sought treatment in emergency rooms in 2007, …

Physician voices

Why rapid viral testing for kids with URIs may not help in the ER

MedPage Today

October 12, 2009Oct 12, 2009

Originally published in MedPage Today by Todd Neale, MedPage Today Staff Writer Rapid viral diagnostic testing did not reduce the burden of treating children with respiratory symptoms and fever in the emergency department, according to a Cochrane Review meta-analysis. Pooling…

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Rapid viral diagnostic testing did not reduce the burden of treating children with respiratory symptoms and fever in the emergency department, according to a Cochrane Review meta-analysis.

Pooling the results of four trials, researchers found a significant reduction in the use of chest radiography (RR 0.77, 95% CI 0.65 to …

Physician voices

Will more primary care doctors keep patients out of the ER?

Edwin Leap, MD

October 9, 2009Oct 9, 200911

One of the many questions asked in the health-care reform debate is ‘how do we keep people out of emergency departments in order to reduce costs?’ Simply put, we probably can’t. And 16 years into my emergency medicine practice, I…

Having taken my own children to the emergency department, even I have been surprised at the charges generated. But we should step back and remember that emergency …

Hospital medicine

Articles, page 149

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