MedWorm: Anesthesiology Blogs

'How' trumps 'what' in patient experience success

hospital impact — Thu, 23 May 2013 12:40:02 +0100

by Jason A. Wolf Since my last blog post where I stressed the need for our continued commitment to push the patient experience movement forward I have had a positive, life-changing experience. Early on Friday, April 19th as we were wrapping up Patient Experience Conference 2013, my wife called to let me know she was having contractions. "Nothing imminent," she calmly told me. It is not often you spend three intense conference days stressing the critical importance of patient experience--of people and process, patient perspective, strategic imperative--only to turn around and be that patient or family member yourself. But those three days were followed by three days admitted to the hospital--experiencing labor and delivery (L & D), post-partum care and watching everything our careg...

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Cardiology Online Test Series 2

Cardiophile MD — Wed, 22 May 2013 00:50:01 +0100

Cardiology Online Test Series 2 Time limit: 0 Quiz-summary 0 of 30 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 You are welcome to try this Cardiology MCQ set and share it among your friends. We strongly advise you to verify the answers with standard text books. You have already completed the quiz before. Hence you can not start it again. You have to finish following...

Hitachi and PENTAX Collaborate on HI VISION Preirus Ultrasound

Medgadget — Tue, 21 May 2013 19:18:49 +0100

Hitachi has released its HI VISION Preirus ultrasound system that it developed in conjunction with PENTAX. The system can be used in most ultrasound imaging situations, including OB/GYN, in interventional procedures, and for transesophageal cardiac echos thanks to an optional add on.From a PENTAX news release:Read More (Source: Medgadget)

Cardiology Online Test Series 2

Cardiophile MD — Tue, 21 May 2013 16:30:51 +0100

Time limit: 0 Quiz-summary 0 of 30 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 You are welcome to try this Cardiology MCQ set and share it among your friends. We strongly advise you to verify the answers with standard text books. You have already completed the quiz before. Hence you can not start it again. You have to finish following quiz, to start this quiz: ...

Nihon Kohden’s New Lightweight Mobile Transport Monitor

Medgadget — Tue, 21 May 2013 15:15:52 +0100

Japan’s Nihon Kohden is releasing in the U.S. its new patient transport monitor. The device weighs 3.5 pounds (1.5 Kg), features a touch screen 5.5 inch (14 cm) screen, and keeps track of a 12-lead ECG, respiration, pulse oximetry, patient temperature, blood pressure, and a few other things. The device records unusual events for later analysis, as well as trends that clinicians can use to get a better perspective on a patient’s condition.The system includes a removable battery that will keep the monitor running for five hours and a memory card stores all the readings for easy data transfer once the patient arrives at the hospital.Read More (Source: Medgadget)

Just what is healthcare reform anyway?

hospital impact — Tue, 21 May 2013 02:40:01 +0100

by Jonathan H. Burroughs That was a question a physician asked me at dinner last week and I answered simply, "World-class quality, safety and service at half the price." Healthcare reform/transformation is a problem in the guise of a political conflict. What the two political parties argue over is who has the legal right to control and regulate the healthcare market: the federal government, state governments or private industry. This is a war that has been waged since we began as a nation and it shows no sign of slowing. Unfortunately, while corporate lobbyists spend hundreds of millions of dollars to defend their entrenched positions, our country is losing the increasingly global competition to provide high-quality, low-cost healthcare services. Medical tourism is the fastest growing...

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Ketamine Associated With Rapid Antidepressant Effect In Largest Clinical Trial To Date

PharmaGossip — Mon, 20 May 2013 04:00:00 +0100

Also Included In: Pain / AnestheticsArticle Date: 20 May 2013 - 1:00 PDTCurrent ratings for:Ketamine Associated With Rapid Antidepressant Effect In Largest Clinical Trial To DatePatient / Public:Healthcare Prof:Patients with treatment-resistant major depression saw dramatic improvement in their illness after treatment with ketamine, an anesthetic, according to the largest ketamine clinical trial to-date led by researchers from the Icahn School of Medicine at Mount Sinai. The antidepressant benefits of ketamine were seen within 24 hours, whereas traditional antidepressants can take days or weeks to demonstrate a reduction in depression. The research will be discussed at the American Psychiatric Association meeting on Monday, May 20, 2013 at 12:30 pm in the Pres...

Revealed Government Documents Show Vaccine Injured Children in Small African Village Used Like Lab Rats

vactruth.com — Sun, 19 May 2013 10:29:53 +0100

Conclusion The parents’ requests are simple and the same as any other parent left in this impossible situation. They feel deserted and betrayed by the Chadian government, who have left their children to die, while at the same time announcing the vaccination program to be a success. All the parents are very angry and are pleading with the world to help. They state they need lawyers, doctors, medication and above all, support. This whole debacle has been a coverup from the very beginning. One of the children’s relatives has told me that there has never been a case of meningitis in this part of Africa. So, why vaccinate children needlessly for a disease that does not exist in this area? Worse still, according to my source, this particular part of Chad is not even on the meningitis bel...

GoogleFOAM

Life in the Fast Lane — Fri, 17 May 2013 21:06:47 +0100

The expansion of the FOAM world is a bit like blowing up a balloon. The early stages involved a lot of effort for a small increase in size, but as it gets bigger, the resistance is falling away and expansion is getting faster and faster. Obviously this is a good thing. But it can make it easier for us all to get lost and there is the danger of information overload — indeed, I’ve written a guide to (in)sanity in the age of FOAM that I continually update, the LITFL post on Information Overload. The FOAM world is now impossible to keep up with. We need to be able to find what we want when we need it, according to our knowledge needs. One of the great developments for ‘just in time’ learning is the creation of GoogleFOAM by Vancouver-based EM Physician Todd Raine (@RaineDoc...

Organizing principles: Classifying pain for healthcare, research | Pain Research Forum

Psychology of Pain — Fri, 17 May 2013 18:35:00 +0100

Where does it hurt? How bad does it hurt? Why does it hurt? The many inconsistent and inadequate ways of sorting chronic pain by anatomy, severity, and associated medical conditions are impeding the health and well-being of patients, optimal medical care, and treatment advances, say pain experts who are calling for a change. This spring, two major efforts are taking shape to fill a widely perceived need for standardized worldwide diagnostic criteria to classify all chronic pain conditions (Finnerup et al., 2013; IOM, 2011; Rief et al., 2012; Rief et al., 2010; von Hehn et al., 2012). One, the International Association for the Study of Pain (IASP) Classification of Pain Diseases Task Force, is working under the auspices of the World Health Organi...

ASA: Doctors and nurses are simply not one and the same

Kevin, M.D. - Medical Weblog — Fri, 17 May 2013 01:00:58 +0100

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Recently, discussion about health care has reached a fever pitch, between changes in policy, adjustments to scope of practice and a multitude of other medical issues. As health care providers, it is our duty to provide the highest level of medical care to all patients to safeguard their health. We are the catalysts for change and we need to recognize practices and beliefs that are potentially harmful to those we’ve vowed to protect. Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how. (Source: Kevin, M.D. - Medical Weblog)

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R&R in the FASTLANE 031

Life in the Fast Lane — Thu, 16 May 2013 00:00:49 +0100

Our currently highly irregular series of eminence-based evidence is finally back again – with the 31st edition: A free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains 11 recommended reads. Find out more about the R&R in the FASTLANE project here and check out the team of contributors from all around the world. This edition’s R&R Hall of Famer Young NS, Ioannidis JP, Al-Ubaydli O. Why current publication practices may distort science. PLoS Med. 2008 Oct 7;5(10):e201. doi: 10.1371/journal.pmed.0050201. PubMed PMID: 18844432; PubMed Central PMCID: PMC2561077 This ...

Paper-Thin Device Performs Pulse Wave Monitoring in a Tiny Package

Medgadget — Wed, 15 May 2013 18:56:50 +0100

Engineers at Stanford developed a tiny new sensor that is capable of monitoring the pulse with impressive resolution. About the size of a postage stamp, the device can be worn under a bandage on one of the body spots where a pulse is easily felt.The flexible pressure-sensitive organic thin film transistors inside the device feature “maximum sensitivity of 8.4 kPa−1, a fast response time of <10 ms, high stability over >15,000 cycles and a low power consumption of <1 mW.,” according to the study appearing in Nature Communications. These parameters allow the sensor to not only detect the main peak of the pulse, but also the recoil pressure, hence to analyze the elasticity of the arterial tree (a parameter that can change with age, with medical conditions like l...

Physio-Control’s TrueCPR Device Nearly Guarantees Perfect Chest Compressions (w/video)

Medgadget — Tue, 14 May 2013 19:34:07 +0100

Performing chest compressions in CPR is a fairly simple process easily explained to most laymen, but execution is key. You don’t want to be breaking ribs, but you certainly don’t want to under-pump the patient with even graver results. Physio-Control just launched its new TrueCPR coaching device, a system that accurately measures the rate and depth of chest compressions and provides both real-time feedback and follow-up analysis of the supplied treatment.The device uses a technique called Triaxial Field Induction to continuously measure the distance between the two parts of the device, one placed below the patient and one directly on the chest. A readout on the chest unit displays the depth of each compression as it’s being performed, as well as the rate at which you&...

Signos RT, or Sonimage P3, Handheld Ultrasound Receives FDA Approval

Medgadget — Fri, 10 May 2013 17:00:43 +0100

Signostics (Thebarton, South Australia) has received FDA 510(k) clearance to market its Signos RT handheld ultrasound device in the United States, where it will be sold as the Sonimage P3. The Signos RT is a handheld self-contained portable ultrasound imager with an attached probe, and is one of the smallest ultrasound devices available. The RT is the successor to the the original Signos device which has been on the market since 2009. The new device has already been available in Europe and Australia for some months.The Signos RT offers real-time B-Mode, M-Mode and PW (pulsed wave) Doppler imaging and volume measurements. It weighs less than 400 grams (14 ounces) and is targeted for quick and simple point-of-care applications such as e-FAST, pneumothoraces, AAA screening, bladder volumes,...

SEDASYS Propofol Sedation System Gets FDA Nod

Medgadget — Fri, 10 May 2013 04:59:05 +0100

Ethicon Endo-Surgery, a Johnson & Johnson company, announced that the FDA granted PMA approval for its SEDASYS device, the first computer-assisted personalized sedation (CAPS) system for use by clinicians in the endoscopy suites.In other words, the system aims to replace anesthesiologists and CRNAs with computerized technology to administer propofol and to monitor minimal-to-moderate sedation in patients undergoing upper and lower endoscopies. According to the company, only ASA class I and II patients are eligible to receive propofol via SEDASYS.Read More (Source: Medgadget)

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Masimo RAS-125c Acoustic Respiration Cloth Sensor Now FDA Cleared for Pediatric Use

Medgadget — Thu, 09 May 2013 16:28:37 +0100

Masimo announced receiving FDA approval for the company’s RAS-125c Acoustic Respiration Cloth Sensor to be used for monitoring breathing in pediatric patients in post-op settings.Previously approved for adult use, the sensor is worn on the neck where it listens to the upper airway and relays the readings to a display unit.Read More (Source: Medgadget)

Philips ClearVue 650 Ultrasound with Auto Face Reveal, Fetal STIC (w/video)

Medgadget — Wed, 08 May 2013 17:54:14 +0100

Philips has released the ClearVue 650, a small footprint ultrasound for general purpose applications that also includes some advanced technologies specifically for Ob/Gyn.It provides all the standard 2D and 3D/4D/Doppler capabilities, but also includes Auto Face Reveal and Fetal STIC (Spatio-Temporal Imaging Correlation) for doing cool 3D reconstructions as seen in the image.Read More (Source: Medgadget)

nPulse Valve Platform from NP Medical for Infusion Therapy

Medgadget — Wed, 08 May 2013 17:50:32 +0100

A new line of needle-free connectors for infusion therapy from NP Medical (Clinton, MA) received FDA clearance to come to market in the U.S.The nPulse Valve Platform sports “non-refluxing fluid displacement, high pressure rating to 325 psi, a flat swabable surface and a clear housing for direct visualization of the fluid path which facilitates clinical decision-making,” according to the press release.Read More (Source: Medgadget)

Alpinion E-Cube 7 Ultrasound for Anesthesia Needle Placement, General Clinical Use

Medgadget — Tue, 07 May 2013 17:58:40 +0100

Alpinion Medical Systems (Seoul, Korea) has unveiled its new E-CUBE 7 ultrasound system at the Annual Regional Anesthesiology and Acute Pain Medicine Meeting (ASRA) in Boston last week. The device is designed to be used during regional anesthesia procedures and pain blocks where needle tracking is a key component for procedural success.Besides regional block applications, the E-CUBE 7 can be used in many of the procedures in which general ultrasound imaging is needed.Read More (Source: Medgadget)

Chris Christie Lap Band Surgery

Inside Surgery — Tue, 07 May 2013 17:15:31 +0100

We are following with interest the news reports today of the Chris Christie lap band surgery. Although we are not participating in his care, some general information on what lap band or laparoscopic gastric banding and typical clinical issues to be considered is detailed below. Lap band surgery is a commonly performed surgical operation done for the control of morbid obesity. It is best performed by experienced bariatric surgeons and is sometimes referred to as the “mini” weight loss surgery. However, while the surgery is not as extensive as the roux-en-Y reconfiguring of the gi tract, it is a operation that is always done under general anesthesia and has a well-known complication and morbidity rate. However, the weight loss experienced by patients who undergo this procedure c...

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A Bold New Vision for Meditech

Life as a Healthcare CIO — Tue, 07 May 2013 10:00:00 +0100

I have no financial relationships with any EHR vendor, but feel a great affinity for the vendors in Massachusetts - eClinicalWorks, AthenaHealth and Meditech.For the past few years, I've suggested to Meditech that cloud hosted, standards-based, web-centric and mobile enabled hospital information systems would be very welcome by the marketplace.The industry has had a mixed reaction to Meditech version 6, a proprietary, non-standard, non-web, non-cloud, non-mobile, client/server application that requires complete hardware and software replacement when upgrading from version 5.I spent last Monday afternoon at Meditech and can tell you that they have listened to industry feedback (and my obsessive focus on web-based applications).The Meditech senior team demonstrated version 6.1, a cloud...

Let’s critically examine what residents are doing while in training

Kevin, M.D. - Medical Weblog — Sun, 05 May 2013 15:00:52 +0100

Recently, I was having a discussion with a colleague about being a doctor. She confided in me that if someone asked her about becoming a doctor, she would tell him or her to become a nurse practitioner. After reading the emotional open letter to our policymakers in Washington DC, it may sound like a reasonable suggestion. After all, why go into this much debt and spend so much time in training if your prospects are not much better? More recently, the New York Times article points out job prospects for radiology trainees are thinning, meaning the well known “ROAD” (radiology, ophthalmology, anesthesiology, and dermatology) to success may soon become a road to nowhere if there are no jobs. Continue reading ... Your patients are rating you online: How to respond. Manage your online...

UnitedHealth CEO Continues to Prosper While His Company's Behavior Appears to Contradict its Mission Statement

Health Care Renewal — Fri, 03 May 2013 19:47:00 +0100

Tis spring, the season in the US for legal settlements, government findings, and proxy statements revealing executive compensation. Therefore, maybe there should be no surprise that we are seeing a series of cases in which health care corporate leaders continue to enrich themselves while their organizations' behavior raises ethical questions.Following on the Amgen example, we now present the latest UnitedHealth example (in a post organized similarly.)The CEO Gets RicherLast week, the Associated Press (via the Washington Post) summarized UnitedHealth CEO Stephen J Hemsley's growing pile of money:UnitedHealth Group Inc. kept CEO Stephen J. Hemsley’s salary stable in 2012 but bumped up his total compensation for a year in which the nation’s largest health insurer grew earnings and e...

ARROW VPS G4 Helps Navigate The Heart for Precise PICC Line Placement

Medgadget — Thu, 02 May 2013 17:39:04 +0100

Teleflex out of Limerick, PA received U.S. regulatory clearance to bring to market its ARROW VPS G4 Device, a system that combines micro-Doppler ultrasound technology and intravascular ECG to help position the tip of a central catheter, specifically in the lower 1/3 of the superior vena cava and cavo-atrial junction. From the announcement:The new ARROW VPS G4 Device offers state-of-the-art design and technology, providing easy-to-follow symbols with further enhancements such as statement of final catheter position, improved sterile field capability, and Wi-Fi access to enable integration with hospital data management systems.Read More (Source: Medgadget)

Feeding tubes and weird ideas

Ballastexistenz — Thu, 02 May 2013 15:54:18 +0100

My favorie BADD post: Tube-ageddon. I haven't had much time to write anything here about the hell I went through getting my GJ tube. I had every indication for a GJ tube. I had gastroparesis so bad it was starting to affect my breathing, in a way that doctors said was likely to result in infection after infection until I died. From the emergency room onward, doctors were saying my best hope was to get a feeding tube. Yet the pressure I got from doctors, while in the hospital for one of those infections, was to just keep getting infections, go home, wait to die. Most of them wouldn't say that outright. But some of them did. Some of them we confronted and they absolutely agreed that the only alternative to the tube was death — which could have happened to me by now, witho...

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Research that Transfusion of "Older" Blood May Be Harmful to Patients

Lab Soft News — Wed, 01 May 2013 13:00:00 +0100

There was a time when I, in a previous incarnation as a blood banker, spent a lot of time thinking about the shelf life of blood and how to increase the utilization of blood in blood bank inventory. Hence, a recent article about this topic caught my eye, partly out of a sense of nostalgia (see: The Shelf Life of Donor Blood). Here is an excerpt from it: For decades, the Food and Drug Administration has limited storage of refrigerated red blood cells to 42 days. But it has been clear for some time that stored blood degrades in various ways long before that six-week limit, and some research suggests that the changes may be harmful to patients who receive older blood. Now a study published in the journal Anesthesia & Analgesia has found that after even 21 days, the membranes o...

No Link Between Anesthesia, Dementia in Elderly

Alzheimer's Reading Room, The — Wed, 01 May 2013 04:00:00 +0100

Elderly patients who receive anesthesia are no more likely to develop long-term dementia or Alzheimer’s disease than other seniors, according to new Mayo Clinic research. +Alzheimer's Reading Room The study analyzed thousands of patients using the Rochester Epidemiology Project -- which allows researchers access to medical records of nearly all residents of Olmsted County, Minn. The study found that receiving general anesthesia for procedures after age 45 is not a risk factor for developing dementia. The findings were published online in Mayo Clinic Proceedings. Subscribe to the Alzheimer's Reading Room Email: Researchers know that some elderly patients have problems with cognitive function for weeks, sometimes months, following surgical procedures, says senior author ...

Implementing Health Reform: Little Rulemaking, But A Steady Stream Of Guidance & A Streamlined Application

Health Affairs Blog — Tue, 30 Apr 2013 15:14:22 +0100

So far, late April 2013 has brought little in the way of formal rulemaking under the private insurance reform and Medicaid titles of the Affordable Care Act. The implementing agencies, however, (the Centers for Medicare and Medicaid Services (CMS) of the Department of Health and Human Services (HHS), the Department of Labor, and the Department of Treasury) have been issuing a steady stream of guidance in the form of Frequently Asked Questions (FAQs) illuminating issues that have arisen under both titles. On April 29, 2013, the agencies issued ACA Implementation FAQs-Set 15 addressing a range of these issue. The first FAQ answers the question of whether a health plan that was granted a waiver from the annual dollar limit prohibition under the “mini-med” waiver program can extend the ex...

Civil War Amputation Surgery Mortality Rates

Inside Surgery — Mon, 29 Apr 2013 04:32:29 +0100

Civil War amputation surgery was distressingly common and carried a high mortality rate. Contrary to common thinking, almost all amputation surgery was carried out under ether or chloroform anesthesia and morphine was readily available for post-operative care. The main problem in amputation that caused a high mortality was wound infection. The following is the mortality rate suffered by Union soldiers with the described level of amputation toes – 6% below the knee – 33% at the knee – 58% thigh – 54% hip joint – 83% fingers – 3% forearm – 14% upper arm – 24 % The post Civil War Amputation Surgery Mortality Rates appeared first on InsideSurgery Medical Information Blog. (Source: Inside Surgery)

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Trying to sort out all the STEM and STEM related departments, graduate programs , at #UCDavis

The Tree of Life — Sat, 27 Apr 2013 04:00:00 +0100

Well, I was in a meeting yesterday for the UC Davis ADVANCE program. This program is an NSF funded project to improve presence of women and underrepresented minorities on the faculty in Science, Technology, Engineering and Math (STEM). So I decided to see - how many departments at UC Davis might participate in such an initiative. And, well, wow. I knew there were a lot of STEM or STEM-related departments at UC Davis but I did not know there were this many. Here is a list I compiled of UC Davis STEM or STEM-related Departments. I included medical departments here since many people in such departments do medical/science research. But clearly this is a broad definition of STEM. But nevertheless, this gives some picture of the scope of science an...

Medicaid Pay Increase For Hospitalists Confirmed For 2013-2014: ACA Rules We Are Qualified Primary Care Providers.

The Happy Hospitalist — Wed, 24 Apr 2013 04:00:00 +0100

Are hospitalists going to get a Medicaid pay raise for 2013 and 2014? The answer is yes, hospitalists qualify for Medicaid parity (with Medicare) as required by the Affordable Care Act (ACA). For many states, Medicaid pays physicians and other providers a small fraction of Medicare rates. Legislation signed as part of the ACA mandates Medicaid rates to equal 100% of Part B Medicare rates in calendar year (CY) 2013 and 2014. That means if you haven't already seen increased rates, and you are a qualified physician providing qualfied primary care services, you will get increased Medicaid payments retroactively applied to January 1st, 2013. When folks think of primary care, most likely think of the outpatient clinics for pediatrics, family medicine and internal...

Medicaid Pay Increase For Hospitalists Confirmed For 2013-2014.

The Happy Hospitalist — Wed, 24 Apr 2013 04:00:00 +0100

Are hospitalists going to get a Medicaid pay raise for 2013 and 2014? The answer is yes, hospitalists qualify for Medicaid parity (with Medicare) as required by the Affordable Care Act (ACA). For many states, Medicaid pays physicians and other providers a fraction of Medicare rates. Legislation signed as part of the ACA mandates Medicaid rates to equal 100% of Part B Medicare rates in calendar year (CY) 2013 and 2014. That means if you haven't already seen increased rates, and you are a qualified physician providing qualfied primary care services, you will get increased Medicaid payments retroactively applied to January 1st, 2013. When folks think of primary care, most likely think of the outpatient clinics for pediatrics, family medicine and internal medic...

The LITFL Review 102

Life in the Fast Lane — Tue, 23 Apr 2013 03:05:51 +0100

Welcome to the 102nd edition!The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around.The Most Fair Dinkum Ripper Beaut of the WeekResus.MECliff Reid over at Resus.ME smashes his way to top spot this week, as he brings us 3 great hot-of-the-press articles, that really tackle the core of what we do. He starts off with Another argument for ED thoracotomy - yes that’s right – we know we don’t often g...

What motivates us?

Life in the Fast Lane — Tue, 23 Apr 2013 00:00:33 +0100

One day, in a hospital very close to your own, you are doing an anaesthetic list with a specialist anaesthetist.A very good anaesthetist.One who does cardiac bypasses and liver resections. One who does research. One who doesn’t panic. The thinking woman’s anaesthetist.And you have the privilege of being here with him, for the whole day, eager to learn pearls of wisdom from this Guru. You want to get 5 tubes in. You want to manage torrential bleeding. You want to learn about the difference between cryoprecipitate, FFP and prothrombinex. After all, the reason you are doing this anaesthetic term is to learn how to manage the difficult airway, and make you a better intensivist.And guess what list they give you both? EYES! Goddam EYES! Local anaesthetics! For the whole day! Where ...

Q&A: Are medi-spas safe for laser hair removal and other cosmetic procedures?

Consumer Reports Health Blog — Mon, 22 Apr 2013 15:00:00 +0100

Q: I get a lot of Groupon and LivingSocial offers for medi-spas. What are they, and are they safe? —L.K., Oberlin, Ohio A: Medical spas, also known as medi-spas, offer dermatological procedures such as chemical peels, laser hair removal, and microderm abrasion in a day-spa setting. They are popping up all over the place. There are almost 4,500 medi-spas now listed in the U.S., up from about 900 in 2007. Some are free-standing, others are affiliated with medical clinics. There are no federal regulations for medical spas, and state rules vary, with most states having none. There's also no guarantee that service providers have adequate training or supervision. That could lead to serious risks, especially with procedures that involve anesthesia. Other possible complications (even from...

The Surgery - I Could Never Have Expected This

bipolar.and.me — Sun, 21 Apr 2013 13:55:00 +0100

Mark is freakishly OCD about being on time or early everywhere we go, so when we left to go to the hospital for my surgery, the traffic was bad, it was lightly snowing (yes, I know, on April 19!!), and it appeared we were going to be a bit late. I kept trying to calm him down, telling him they give people huge windows of two to three hours before their surgery even begins to get there. Everyone has their buttons, though. His is traffic, another one of his is finding a parking spot in a parking lot. NOT a good pet peeve living in Chicago. Now *that* I totally dread. I can go from being so excited to being somewhere to telling him to just take me home because it's all been ruined, and it may have all happened in five minutes. It's just that bad. ...

Pain Medicine Care Complex - Children's National Medical Center

Psychology of Pain — Sun, 21 Apr 2013 12:24:00 +0100

Children's Pain Medicine Care Complex is one of only a few programs in the country focused exclusively on managing pain for infants, children, and teens. When children are unable to express their pain in words, our pediatric specialists have the unique insight to help. Our multidisciplinary approach enables us to treat your child's physical symptoms as well as the psychological and emotional aspects of pain. We consider how a child feels and perceives pain, and take steps in care to reduce their fears and their family's anxieties. Conditions We Care For There is no typical pain patient. The team looks at every part of a child's pain. We develop a unique treatment plan that may blend traditional medicine and alternative therapies to best fit the needs of each patient.The team...

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In Gaming, Some See Tools to Treat Pain - NYTimes.com

Psychology of Pain — Sun, 21 Apr 2013 12:13:00 +0100

WASHINGTON — Fifteen-year-old Reilly woke up one morning with a sharp, stabbing pain in his left leg that soon spread to other parts of his body. The pain, which started early last year, forced him to quit soccer, and he spent the next four months being poked, prodded and scanned by doctors.The test results were inconclusive. "No one could tell him why he was in a ball on the floor unable to function," said Nina, his mother, who agreed to be interviewed only on the condition that the family's surname be withheld.Finally, last June, Dr. Sarah Rebstock, a pediatric anesthesiologist at Children's National Medical Center, gave Reilly a diagnosis of chronic regional pain syndrome. The nerve disorder is characterized by chronic and severe burning pain, pathological changes in bone and skin, ex...

Zap.

Trauma Queen — Sat, 20 Apr 2013 13:23:09 +0100

0800 Terrible nights sleep. Hopefully I’d be tired after the op. All advice is that the best thing to do is go to sleep afterwards as apparently it helps the cornea heal. 1100 Sat in the waiting room of the laser clinic, the sun bright and cold outside, four others sitting around and waiting to be seen. I wonder if we’ll become a little happy band of laser victims, cheering each other on as we go in and out, like contestants on a reality TV show. A woman walks out of the treatment rooms, squinting and smiling before pulling sunglasses on and walking out with her husband…”I’m not too bad….” she mentions, sounding surprised. I’m feeling optimistic. In the corner, rolling coverage of the Boston man hunt. Newsreaders struggle to say something o...

Anesthesiologists are victims of their own success

Kevin, M.D. - Medical Weblog — Thu, 18 Apr 2013 11:00:48 +0100

New research just out in the journal Psychology and Aging says pessimists live longer and healthier lives. If this is true, then contemplating the future of anesthesiology ought to make us immortal, because our professional prospects don’t look bright. As we teach residents to do what we’ve always done, shouldn’t we ask ourselves honestly if we’re training them for a future that doesn’t exist? Especially here in California, it seems likely that our predominantly MD-provided, fee-for-service practice of anesthesiology will not survive indefinitely, and perhaps not for long. We can blame the reelection of President Obama and the passage of the Affordable Care Act if we like, but the reality is that market forces were eventually going to catch up with us whether or not Mitt Romn...

TechTool Thursday 025

Life in the Fast Lane — Thu, 18 Apr 2013 01:07:22 +0100

TechTool review of drawMD – Anesthesia & Critical Care by UrologyMatch on iPad Website: – iTunes - Website drawMD is a beautiful app for the iPad that allows you to explain procedures and illnesses to your patients by using customised diagramatic visual aids. The app provides templates for anatomical explanations and you can customise these by adding extra stamps or your own drawings. Clinical Content The app has 11 basic background pictures to get you started and any details can be added on top of this. These include: arm, chest, spine, heart and abdomen. To illustrate an example (see the images below) you can start with the chest background (image 1) to explain insertion of a chest tube for a pneumothorax. The app has several ‘stamps’, which are pre-design...

Covidien’s New Shiley Cuffless Neonatal and Pediatric Tracheostomy Tube

Medgadget — Wed, 17 Apr 2013 19:12:30 +0100

Covidien is releasing a new line of cuffless Shiley neonatal and pediatric trachs, in an expanded range of tube sizes (down to a 2.5mm inner diameter) and with new features such as “a soft, clear flange that facilitates easier examination of the underlying skin for infection and eases trach-tube holder insertion.” More details from the product page: Shiley™ tracheostomy solutions meet the latest safety standards, offering tubes that are manufactured with non-phthalate citric-based plasticizer materialsRead More (Source: Medgadget)

Dental anesthesia may interrupt development of wisdom teeth in children

Dental Technology Blog — Wed, 17 Apr 2013 14:17:00 +0100

Researchers from Tufts University School of Dental Medicine have discovered a statistical association between the injection of local dental anesthesia given to children ages two to six and evidence of missing lower wisdom teeth. The results of this epidemiological study, published in the April issue of The Journal of the American Dental Association, suggest that injecting anesthesia into the gums of young children may interrupt the development of the lower wisdom tooth."It is intriguing to think that something as routine as local anesthesia could stop wisdom teeth from developing. This is the first study in humans showing an association between a routinely- administered, minimally-invasive clinical procedure and arrested third molar growth," said corresponding author, Anthony R. Silvestri,...

The Little Mermaid And Breast Implants

Cranky Fitness — Wed, 17 Apr 2013 04:00:00 +0100

While Crabby is taking a week off on vacation, Cranky Fitness is honored to present... A guest post by Gaye of Confetti Drop! Once upon a time, in my early 30's, I was in slamming shape. 5'2", 110 pounds, 16% body fat. This came after having topped the scales at over 200 pounds, so I was pretty much living the dream! It was the very first time in my life that I didn't have “thigh balls,” or what others refer to as saddle bags. Thing 1 and Thing 2 were gone! It was a miracle!!! But sadly, gone too were my breasts. I had never been well endowed. All through high school and college I was the girl in the Izod, often bra-less, rocking the tomboy/preppy look. I had always been athletic and my body suited me. I could do what I wanted and my little size A's would happily bound al...

Boston Marathon Terrorist Attack and Injuries

Inside Surgery — Mon, 15 Apr 2013 23:26:28 +0100

Like all Americans, we were horrified to hear of the terrorist act today at the finish line of the Boston Marathon. While reports are still coming in, there were at least two people killed and numerous people injured, some critically. This event hits home for us at InsideSurgery.com in several ways. First, this writer, who is a trauma surgeon, attended the Boston Marathon last year as a spectator and managed to wangle a spot right at the finish line where the first bomb went off. Last year on Patriot’s Day as I made my way across the Boston common and toward the corner of Boylston and Ring Avenue I was amazed and a little intimidated by the crush of humanity on the streets of Boston. At the finish line, which I had to step on tip toe to see, the crowd that I stood in across the stre...

Teleflex ISO-Gard Mask Keeps Waste Anesthesia Gas Away from Clinicians in PACU (w/video)

Medgadget — Mon, 15 Apr 2013 20:29:13 +0100

When patients after general anesthesia arrive to the recovery room, they continue to exhale residual anesthetic agents, as these drugs redistribute themselves from tissues back to blood and out through the lungs. And if you are a PACU nurse, then you probably can even smell what anesthetic agent a patient was on. Consequently, all this smell of Waste Anesthetic Gas (WAG) is not good for anyone in PACU, as molecules of vapor anesthetics circulate in air and can cause multiple short and long term problems, according to OSHA.Teleflex Medical (Research Triangle Park, NC) received FDA clearance for its ISO-Gard anesthesia mask that solves this problem by recovering much of the exhaled gas and sending it to the vacuum exhaust. The system works by running oxygen through the breathing area in in o...

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i'm so sleepy — Mon, 15 Apr 2013 16:28:00 +0100

A patient's family in the waiting room wearing "I <3 Team [surgeon's name]" tshirts. I can't imagine them wearing "I <3 Team Anesthesia". Not that I mind really (Source: i'm so sleepy)

Samsung Unveils Its Own Mobile Ultrasound System, UGEO H60 (w/video)

Medgadget — Mon, 15 Apr 2013 14:36:51 +0100

Samsung, continuing its push into the medical device space, has released a new multi-purpose ultrasound to the U.S. market. Dubbed as the UGEO H60, the system features what sounds like a high resolution doppler feature called S-Flow, or as in the press release, “an innovative function that enables color detection with superior sensitivity, that allows even micro vessels to appear in high resolution.”The imaging screen is an ample 18.5″ LED monitor and all the controls are done on the panel below with a touchscreen monitor. The UGEO H60 also features a built-in heater that will keep your ultrasound gels at a desired temperature.Read More (Source: Medgadget)

FDA Drug Shortages: Fundamental Problem is the Inability for the Market to Observe and Reward Quality

Policy and Medicine — Fri, 12 Apr 2013 04:00:00 +0100

Conclusion Ultimately, the FDA officials argued that “the fundamental problem with injectible shortages is insufficient market reward for quality (including reliability of production) stemming from the buyers’ inability to observe it.” This in turn gives manufacturers strong incentives to minimize quality system investments, especially when faced with pressures brought about by new production opportunities, aging facilities, and the recent economic downturn. Until new incentives are provided to improve quality, it is uncertain whether generic-injectable makers will adequately address quality issues. (Source: Policy and Medicine)

I’m starting to heal here.

Ballastexistenz — Thu, 11 Apr 2013 23:23:19 +0100

The hospitalization started awful but got better after the Internet convinced the hospital that lots of people care what happens to me. Since not everyone has that resource, my goal once I get better is to work hard on a non discrimination policy that will prevent any other patient from going through what I went through. I don't have the energy to go through the whole story again. But basically my gastroparesis was getting so severe that I could no longer keep up a minimal Iiquid diet and was also aspirating frequently as the gastroparesis got more severe (due to gas bubbles from food sitting forever in my stomach), leading to getting pneumonia so often that it was clear my life was in danger. And I was dropping weight in ways that nobody should ever drop weight, fat or thin. So I ne...

Mobisante Unveils Tablet-Based Ultrasound Imaging System

Medgadget — Thu, 11 Apr 2013 19:31:35 +0100

Mobisante (Redmond, Washington) released its MobiUS TC1 ultrasound system, a tablet version of its MobiUS system that until now was only available in a smartphone format. The system offers a large high resolution screen for performing all kinds of exams including “trauma (FAST exam, lung, cardiac screening), abdominal pain, AAA and other routine screening such as bladder assessment, OB/GYN assessments, triage, ultrasound-guided procedures and much more,” according to the announcement.In addition to standard transducer probes, the TC1 also works with endocavity probes for gynecological work and imaging the prostate.Read More (Source: Medgadget)

Monitors, patient safety and common sense

Dr John M — Wed, 10 Apr 2013 04:00:00 +0100

Patient safety and hospital quality is a scary topic. I’ll go easy. I’m just a doctor. I don’t know much. Entire departments, filled with cubicles, computers and well-meaning people, now exist to keep hospitals tightly regulated and running perfectly. There is data to analyze, regulations to read, and oh so many meetings to attend. This place of healing will be safe—and perfect. The most recent Sentinel Alert issued from the all-powerful Joint Commission caught my eye. It appears we have a problem with hospital monitors. First the monitors, then the matter of whether patients are dying from medical errors. From the JC: Hospital monitors are monitoring too much; they beep too loudly and more than 80% of the time, the alarm was false. These facts have led caregivers, who all are ...

The LITFL Review 101

Life in the Fast Lane — Mon, 08 Apr 2013 09:53:57 +0100

Conclusion: Imaging and repeat imaging in sciatic doesn’t really change the management..So why do it then! Focus Article: Early Imaging After Arrest Often Finds the Culprit. Bottom line from this study: The use of an early diagnosis protocol with immediate coronary angiography and/or CT scan provided the etiology of nearly two thirds of OHCA cases. ECG of the Week ECG of the Week – It looks bad and wide – whats going on! Ultrasound Podcast ULTRASOUND OF RADIUS FRACTURE! What? That’s right. Diagnose it and guide your reduction with US! TJdogma ICE 007 – another great ICE case, simple, short and informative. Emergency Medicine Tutorials Aortic Emergencies for Junior Docs – Nice detailed overview on the dreaded aortic dissection for the junior clin...

The secret history of psychedelic psychiatry – Neurophilosophy

PharmaGossip — Sun, 07 Apr 2013 04:00:00 +0100

This article will be freely available, with registration, until September 23. See the Table of Contents for more information on this Blog Focus, and read the other blog posts: Serotonin, Psychedelics and Depression (by Neuroskeptic) Ketamine for Depression: Yay or Neigh? (by The Neurocritic) Visions of a psychedelic future (by Vaughan Bell) Update: I summarize all four posts in this article for The Guardian, and there’s more coverage of the Blog Focus at 3 Quarks Daily, The Atlantic (Alexis Madrigal and Andrew Sullivan), Boing Boing and The Great Beyond. ___________________________ ON August 15th, 1951, an outbreak of hallucinations, panic attacks and psychotic episodes swept through the town of Pont-Saint-Esprit in southern France, hospitalizing dozens of its inhabit...

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SRNA Boot Camp

Nurse Anesthetist — Sat, 06 Apr 2013 22:22:20 +0100

It is now April and our new Registered Student Nurse Anesthetist’s (SRNA’s) have been in the OR now since January – just a total of three months now. The progress that they have all made in the operating room really has been tremendous. To see students come into the operating room for the first time, [...] (Source: Nurse Anesthetist)

Physician Payment Sunshine: ProPublica Database Leads with Disparaging Headlines

Policy and Medicine — Wed, 03 Apr 2013 04:00:00 +0100

Doctor collaborates with industry to conduct lifesaving, breakthrough research.” “Doctor educates colleagues about safety and clinical date to improve patient outcomes.” “Physician speaks to peers about new trials that improve patient access to needed drugs.” “Researchers meet to ensure the success of new clinical trial.” “Physician invents new medical device that improves cardiovascular health.” “Industry and physicians collaborate to bring drug to market faster through new approval pathway.” “Physicians attend education program mandated by FDA under REMS to better understand benefits and risk of drugs.” Of all these headlines, few, if any, are ever chosen by mainstream or local media to describe physician-industry relationships and collaborat...

IVF- FAQs - Can I see my embryos before the ET ?

The Patient's Doctor — Tue, 02 Apr 2013 01:57:00 +0100

Yes, good IVF clinic routinely show you your embryos before they are transferred to your uterus. It is the duty of every IVF clinic to show you the embryos they created for you in their lab. We take pride in displaying our clinic’s competency in creating good embryos.http://blog.drmalpani.com/2012/08/the-importance-of-seeing-photos-of-your.html What do my embryos look like ? Your embryos are very minute; it is impossible to see these tiny balls of cells using your naked eye. You need a microscope to view them. Your embryo divides at regular intervals after fertilization and will have a different appearance under the microscope each passing day. There is a set of rules which tell you how your embryos should look for their age ( for example, a day 4 embryo looks entirely differen...

Job Prospects Dimming for Residents in Radiology; Defining the Underlying Problems

Lab Soft News — Fri, 29 Mar 2013 15:51:27 +0100

I closely track job prospects in radiology because of the similarity of the field to pathology. Two years ago, I posted a note about the declining job prospects in radiology (see: Radiology Jobs Trend Downward; Blame Technology and Reimbursement). A recent article provides more evidence about this decline (see: Job Prospects Are Dimming for Radiology Trainees). Below is an excerpt from it: For years, medical students who chose a residency in radiology were said to be on the ROAD to happiness. The acronym highlighted the specialties — radiology, ophthalmology, anesthesiology and dermatology — said to promise the best lifestyle for doctors, including the most money for the least grueling work....Recent radiology graduates with huge medical school debts are having trouble find...

10 Most Costly Financial Mistakes Physicians Make & How to Avoid Them

Non-Clinical Physician Jobs, Careers, and Opportunities — Mon, 25 Mar 2013 04:00:00 +0100

If you are a practicing physician or a medical/surgical intern/resident/fellow, you won’t want to miss this upcoming event on April 25 in Philadelphia titled, “10 Most Costly Financial Mistakes Physicians Make & How to Avoid Them.” Medical schools and residency programs often don’t provide enough information on the following important physician career planning issues: • Evolving landscape of physician employment models and contracts • Financial strategies for investing, managing taxes, & protecting assets • Achieving satisfactory work/life balance and financial freedom As the landscape of healthcare undergoes significant change, all of these issues are becoming more critical. Therefore, we would like to invite you to attend a complimentary informational program wh...

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Goldenhar Boy

Cochlear Kids — Fri, 22 Mar 2013 04:00:00 +0100

So I was lying on the O.R. table (it was actually more like a doctor's office-I had no anesthesia) trying to think of anything to say to drown out that LOUD snipping as the surgeon removed skin and tissue deep within my foot (another skin cancer). I blurted out (in a voice that was a little too loud for the awkward quiet) "So where did my other doctor go?" Realizing instantly my voice was off key and too loud I tried to retract some composure as my blood pressure soared with every SNIP, SNIP, SNIP!!!! "I mean, Dr. C? She's not here anymore right? She always used to ask me questions about my Goldenhar Boy." She knew exactly what I meant when I said the word Goldenhar and she starting spouting off facts she knew to confirm I was referring to the same syndrome, "Does he have any Renal issues...

When the hurting won't stop: How chronic physical pain drove a Calgary teen to take his life

Psychology of Pain — Thu, 21 Mar 2013 12:08:00 +0100

CALGARY – Dominic Boivin's black and brown paisley school backpack sits empty in a corner of his bedroom, near the computer chair where the Calgary teen used to play his Xbox.It's the same backpack his parents watched a police officer carry up their driveway one night last June. Behind the police officer, Dominic's body lay in a medical examiner's van. A citywide search for him was over.On June 6, 2012, Dominic "the Dominator" Boivin — a once-gifted soccer player and honour student with a lopsided grin and a gentle soul — took his life after four years of struggling against constant, mysterious, body-wide pain.At its worst, the pain was so severe Dominic could not walk or eat, and could barely speak. His parents fed him liquids through a child's sippy cup.At its best, the pain was pa...

Four commonly asked questions on AF ablation

Dr John M — Thu, 21 Mar 2013 04:00:00 +0100

I receive a lot of emails from people afflicted with atrial fibrillation. It is humbling that another person would share such highly personal information with me, a stranger. Thanks for that. It goes without saying that I cannot give specific medical advice. Though it is tempting. I’ll read a detailed story and think to myself…OMG, why in the world would they do or say that? And not infrequently a writer paints a picture that I have seen thousands of times. I want to be kind; I want to help. But it’s not even close to right to practice medicine without a patient-doctor relationship. I will continue to resist the urge. But what if we talked about recurring themes/questions that come through emails and office visits? Perhaps addressing such commonalities will shed light on what the sha...

Doctors' Dubious Excuses for Taking Pharmaceutical Companies' Money

Health Care Renewal — Tue, 19 Mar 2013 16:29:00 +0100

This report, and its recommendations have gotten scant attention, maybe because they would threaten a status quo that enriches conflicted health professionals and the companies that create these conflicts. However, in my humble opinion, implementing all the report's recommendations would only be a beginning down the road of restoring the integrity of clinical care, teaching, and research. (Source: Health Care Renewal)

Women and the Treatment of Pain - NYTimes.com

Psychology of Pain — Mon, 18 Mar 2013 16:06:00 +0100

To the list of differences between men and women, we can add one more: the drug-dose gender gap. Doctors and researchers increasingly understand that there can be striking variations in the way men and women respond to drugs, many of which are tested almost exclusively on males. Early this year, for instance, the Food and Drug Administration announced that it was cutting in half theprescribed dose of Ambien for women, who remained drowsy for longer than men after taking the drug.Women have hormonal cycles, smaller organs, higher body fat composition — all of which are thought to play a role in how drugs affect our bodies. We also have basic differences in gene expression, which can make differences in the way we metabolize drugs. For example, men metabolize caffeine more quickl...

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Answering the critics of atrial fibrillation ablation

Dr John M — Mon, 18 Mar 2013 04:00:00 +0100

In the gratifying category, few things rank higher than vanquishing atrial fibrillation with catheter ablation. But yet, not everyone thinks so highly of a procedure that has come to dominate my medical career. Dr Rita Redberg, influential cardiologist and editor of the JAMA Internal Medicine “Less is More” series, said this about ablating AF: “Because ablation has never been studied in a randomized blinded fashion, we cannot know whether patients experience fewer symptoms after ablation because subjective symptoms frequently decrease following a procedure or whether the ablation itself was beneficial. Ffurthermore, the clinical benefit on survival and morbidity of this invasive procedure, which has substantial procedural risks, remains to be established.” Let’...

Saying Goodbye to my Father

Life as a Healthcare CIO — Tue, 12 Mar 2013 17:42:00 +0100

My father passed away this morning. My mother and I were at his bedside telling him we'd be ok and care for each other. He was 70.My parents met when they were 17 and I was born when my mother and father were 19.I've known him for nearly 51 years.The community recalls him as the kindest most giving lawyer in Southern California.To me he was a mentor, a friend, and an inspiration.He told me a story about my early childhood. When I was two years old, I was playing in the backyard of my grandparents home in Iowa. I fell on grass and began crying. It was not injured in any way. He watched the incident and decided not to run over and console me. Instead he let me brush myself off, realize that I could fall, and in a self reliant way recover from i...

ACOs Won't Work According to Clayton Christensen in the WSJ

Lab Soft News — Tue, 12 Mar 2013 13:18:38 +0100

Clayton Christensen and colleagues published a recent op-ed piece in the Wall Street Journal explaining why ACOs won't work (see: The Coming Failure of 'Accountable Care'). I have expressed similar sentiments about these organizations in the past. The concept was invented by the federal government and not by physicians and hospital executives who are responsible for creating and managing them (see: Hospital Executives Search for the Formula for an Accountable Care Organization; ; How to Define and Reduce Unnecessary Services). Most of these incumbents are not that interested in decreasing the cost of healthcare and generally like the status quo. Below is a truncated version of the WSJ article. I am only presenting the highlights so link to the original if you ...

Pain Medicine News - µ-Opioid Receptors Impaired in Fibromyalgia Patients, Study Shows

Psychology of Pain — Fri, 08 Mar 2013 20:30:00 +0100

This study is the first to demonstrate the connection between μ-opioid receptor binding and the brain's response to the pain of fibromyalgia, said lead investigator Richard Harris, PhD, assistant professor in the Department of Anesthesiology and research assistant professor in the Department of Internal Medicine, University of Michigan, Ann Arbor. "In fibromyalgia patients, the main inhibitory mechanisms are not working correctly, specifically the opioid receptors within the brain," he said during his presentation at the 2012 annual meeting of the American College of Rheumatology (abstract 2450).The investigators used functional magnetic resonance imaging to measure changes in blood flow in the brains of 18 female patients with fibromyalgia after they received a painful stimulus, administ...

Painkiller-abuse proposal divides healthcare community, even in same hospitals | cleveland.com

Psychology of Pain — Fri, 08 Mar 2013 20:28:00 +0100

Doctors at top health centers including the Cleveland Clinic and University Hospitals want the U.S. Food and Drug Administration to toughen rules for prescribing powerful painkillers like OxyContin and similar opioids, saying this could curb addiction and drug abuse.Yet there is pushback -- from, among others, medical professionals at some of the same hospitals, including the Cleveland Clinic, public records and interviews show.These doctors and clinicians say they, too, want to halt addiction and deaths from the over-consumption and abuse of opioid painkillers, which the U.S. Centers for Disease Control calls an epidemic. The CDC lists Ohio as among the states with the highest rate of overdose deaths from OxyContin and similar drugs that use synthetic or natural versions of the opium...

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Medscape re: Class Action suit: "Doctors Who Sued EHR Company Win First Round"

Health Care Renewal — Wed, 06 Mar 2013 23:36:00 +0100

Interesting article about a Class-Action lawsuit against a health IT seller, Allscripts, see Medscape link below (the story is copyrighted so I cannot repost it here).Relevant excerpts:On Monday, March 4, a group of doctors who are suing their electronic health record (EHR) manufacturer for selling them a "buggy" product and then discontinuing it learned that the defendant's motion to block the lawsuit and compel them to accept binding arbitration was overruled by a judge in Miami, the first step in getting a court date in what is believed to be a first-of-its-kind case.... In December 2012, 4 physician practices -- 2 pain clinics in Florida, 1 in Missouri, and a family medicine practice in Alabama -- became plaintiffs in a class-action suit filed against Allscripts, "an action arising fro...

Just Sayin

In My Humble Opinion — Sun, 03 Mar 2013 05:00:00 +0100

We have to stop comparing ourselves to the airline industry. Sitting on the lounge chair at the pool, I can't believe that just hours ago I was sludging the wintry streets of Chicago, rushing to the airport. The kids clucked away happily in the back seat as the adults in front where more subdued. As grownups do, we kept running through our mental checklists even though the ship had already sailed, we left the house. The trip, in general, was quite smooth. With the exception of seating. For some reason, even though we had made the reservation months in advance, the four of us were sitting in completely different rows. Now, although I miss my wife dearly even when the separation is just for four short hours, for the little ones sitting by themse...

Peering Underneath the Iceberg's Water Level: AMNews on the New ECRI "Deep Dive" Study of Health IT "Events"

Health Care Renewal — Thu, 28 Feb 2013 14:15:00 +0100

FDA's Center for Devices and Radiological Health director Jeffrey Shuren MD JD voiced the opinion a few years ago that what FDA knows about health IT risks is the "tip of the iceberg" due to systematic impediments to knowledge gathering and diffusion. See links to source here and to the FDA Internal Memo on HIT risk - labeled "internal document not intended for public use" and unearthed by investigative reporter Fred Schulte several years ago - here (PDF).At my Feb. 9, 2013 post "A New ECRI Institute Study On Health Information Technology-Related Events" I opined that a new ECRI study was beginning to peer beneath the waterline of Jeff Shuren's iceberg tip, at what may reside underneath that waterline. Iceberg tips, needless to say, are usually tiny compared to the iceber...

People in a vegetative state may feel pain - health - 23 February 2013 - New Scientist

Psychology of Pain — Wed, 27 Feb 2013 20:56:00 +0100

It is a nightmare situation. A person diagnosed as being in a vegetative state has an operation without anaesthetic because they cannot feel pain. Except, maybe they can.Alexandra Markl at the Schön clinic in Bad Aibling, Germany, and colleagues studied people with unresponsive wakefulness syndrome (UWS) – also known as vegetative state – and identified activity in brain areas involved in the emotional aspects of pain. People with UWS can make reflex movements but can't show subjective awareness.There are two distinct neural networks that work together to create the sensation of pain. The more basic of the two – the sensory-discriminative network – identifies the presence of an unpleasant stimulus. It is the affective network that attaches emotions and subjective feelings to ...

The Latest from EchoJournal

Medgadget — Wed, 27 Feb 2013 19:13:14 +0100

We are very proud of EchoJournal, our echocardiography video website. If you are a cardiologist, anesthesiologist, radiologist, medical student, or just a person interested in cardiac ultrasounds, EchoJournal is the place for you. To learn and discuss, you can review new cardiac videos that are added on a regular basis, or you can browse through our video archives. To store or share, you can upload your own clips. The site has a growing membership base and your expertise benefit greatly by joining. EchoJournal is curated by David E. Winchester, MD, a cardiologist at the University of Florida.The site offers many user choices: keep videos private for storage or post them for discussions, embed videos on your own page, organize groups, channels, and more.Read More (Source: Medgadget)

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The Blog is only as loud as the blogger

Life in the Fast Lane — Wed, 27 Feb 2013 17:36:09 +0100

At LITFL and in the froth of #FOAMed we are constantly faced with a barrage of negative, cynical and disparaging comments on the role of the blog and social media in the provision of medical education and patient engagement. I thought it would be worthwhile to post one of the more erudite commentaries on the subject, from a source that shall remain anonymous… The Blog is only as loud as the blogger! Information is powerful and power is dangerous in the hands of the illiterate! If it is FREE it must be good! They are giving out free tickets to live in Broken Hill, would you take it!!! How is a blog different to any research articles, just because it can be criticized online and is uncensored…? Bloggers are confident people who are bold enough to put their views out there; but doe...

ALung Technologies Hemolung Respiratory Assist Device Cleared in Europe

Medgadget — Tue, 26 Feb 2013 16:45:39 +0100

Pittsburgh based ALung Technologies won the European CE Mark to begin introducing the Hemolung Respiratory Assist System (RAS). The device, intended for people suffering from acute lung failure, performs the essential duties of a lung, removing CO2 from blood and oxygenating it. The partial respiratory support takes the load off the organ and gives it a chance to heal.The procedure is similar to renal dialysis, with a venous catheter used to pass the blood to and from the Hemolung.Read More (Source: Medgadget)

My IVF journey - a first hand account from a patient

The Patient's Doctor — Tue, 26 Feb 2013 02:10:00 +0100

This is a guest post . The writer was inspired to pen this after reading Manju's blog at www.myselfishgenes.blogspot.com. She sent this to Manju, and I asked for her permission to reproduce this. I hope more patients will start documenting their experiences. Not only is this helpful for them ( because it allows them to vent ), it also provides them with a platform to share their hard-earned learning , so they can help other patients, so they do not repeat their mistakes ! It articulates very clearly what infertile patients go through . I do wish all IVF doctors would read it too, so they would be a little more compassionate ! I have deliberately not edited this - it's a very personal first person account. ( English is not her first language, so please overlook the grammatical errors and...

The Heart Team: Collaboratively Working to Achieve Common Goals

ACC in Touch Blog — Mon, 25 Feb 2013 21:47:00 +0100

Decision making has evolved over time. Many years ago, when options were limited to either medical or surgical, clinical decisions were relatively simpler and the “Heart Team” was smaller and more cohesive. However, with the introduction of catheter-based approaches in addition to surgery, specialties became more siloed. Today, with choices and treatments more complex than ever, it’s critical that we rekindle the Heart Team approach. Collective input and wisdom from a complement of medical, surgical and interventional experts is needed for optimal decision making. This team approach, inclusive of shared-decision making with patients, is at the crux of patient-centered care. It is also the crux of a State-of-the-Art paper published on Feb. 25 in the JACC by myself and o...

Guest Article: Try not to fall for the Big Data in Healthcare hype, focus on actionable data that can improve clinical workflows

The Healthcare IT Guy — Mon, 25 Feb 2013 14:39:16 +0100

Many readers write to me regularly to ask what I think about “Big Data” in healthcare. I tell them that Big Data in our field is generally more hype than reality right now but that there’s a lot of promise and opportunity. To help elaborate on why this might be the case I’ve asked my friend Naeem Hashmi, Chief Research Officer at Information Frameworks, to give us his thoughts. Naeem has written a number of books on the subject of informatics and analytics and been on the front lines of engineering large scale healthcare systems to generate data for clinical analytical purposes. Here’s what Naeem had to say about Big Data in Healthcare: The Big Data bubble in the Healthcare is just filled with the Hot Air – at least for now. Every one is talking about it but when you dig a ...

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The LITFL Review 096

Life in the Fast Lane — Mon, 25 Feb 2013 10:52:31 +0100

Welcome to the majestic 96th edition! The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around. The Most Fair Dinkum Ripper Beaut of the Week EMCrit Top spot is an absolute ripper on Critical Care Palliation with Ashley Shreves - This is the best ED critical care palliative care lecture ever! Don’t believe me? Then watch it! The LITFL Review Top Picks Resus.ME What does chicken bombs and muppets have to...

NBCRNA Updates

Nurse Anesthetist — Fri, 22 Feb 2013 17:00:30 +0100

There has been so much going on. One of the projects that is in the works is to get others to participate and write for the nurseanesthetist.org web site. I have invited several to submit articles that would be beneficial to the SRNA community. Here I am opening the door to others that may want to write for the web site. Our focus here has been the SRNA but we could open the window a bit and include general anesthesia topics. These ideas would also certainly be welcome reading for the potential SRNA candidate as well as those already in programs. The reason I am writing today is to make sure everyone is aware of the moves in the certification process set forth by the NBCRNA – the certification body for all CRNA’s nationally. Periodically the NBCRNA does a review of ...

Cataracts and clear vision

edwinleap.com — Fri, 22 Feb 2013 02:59:04 +0100

I had my second cataract surgery today. I tolerated it for about two years, but it just became too difficult to see. I was, essentially, using my good eye for everything. I became pretty adept at mono-vision, thank you very much. But enough was enough. Jan finally wearied of watching me hold things too close, or fiercely squint at the television. Cataract surgery is surreal. I lay there, fully awake, as my eye was prepped, anesthetized, opened and the cataract vibrated into tiny bits then gently removed. Before I knew it, I had a shiny new lens where before I was seeing the world through cellophane; wrinkled at that. When I left the surgery center, it was with a face painted in yellow betadine, and enormous black, wrap-around sunglasses. I had to stop and wait in Wal-Mart...

App News

BHIC — Thu, 21 Feb 2013 20:27:47 +0100

Apple launches dedicated ‘Apps for Healthcare Professionals’ collection One of the updates to the Apple App Store recently is the inclusion of a specific collection entitled, “Apps for healthcare professionals”. This collection can be found within the ‘Medical Category’. It is a useful starting point for physicians with new mobile devices looking for relevant apps. The collection is further subdivided into: Reference Apps, Medical Education Apps, EMR & Patient Monitoring Apps, Nursing Apps, Imaging Apps, Patient Education Apps and Personal Care Apps. To read about: http://bit.ly/12SWKtr All drawMD patient education apps go free to celebrate drawMD 3.0 To celebrate the launch of their new software, drawMD have made all their existing apps free so be sure ...

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Rotations

Med Student Guide — Thu, 21 Feb 2013 14:49:00 +0100

by usmleworld1 (Posted Thu Feb 21, 2013 9:49 am)Clinical USA is a profession cooperation that sets up clerkships in the USA for IMG. Clinical USA secures Clinical Rotations (Core and Electives) in Top Rated Teaching U.S Hospitals and Affiliated Medical Clinics. We have the following Core and Elective Rotations available. CORE CLERKSHIP:1. Internal Medicine (12 weeks)2. Obstetrics & Gynecology (8 weeks)3. General Medicine Surgery (8 weeks)4. Surgical sub-specialties (12 weeks) *5. Pediatrics (6 weeks)6. Family Medicine (6 weeks)7. Psychiatry (6 weeks)8. Radiology (4 weeks)9. Clinical Pathology (4 weeks)§ Anesthesiology§ Neurosurgery§ Ophthalmology§ Otorhinolaryngology§ Orthopedic Surgery§ Pediatric Surgery§ Plastic Surgery§ Thoracic Surgery§ Vascular Surgery§ Urology§ Emergency M...

Buckeye Eviscerated on KevinMD

Buckeye Surgeon — Thu, 21 Feb 2013 05:00:00 +0100

The medical social media Godfather Kevin Pho will occasionally cross post some of my work on his hugely popular and successful blog KevinMD. Earlier this week he chose to include my relatively recent post on an article I had read in the Economist last fall about physician assisted suicide (PAS). I was in one of those moods when I wrote it. I suppose I was looking to achieve a certain degree of shock value by writing it as a straight satire of what it could mean to be an actual doctor who participated in PAS. I mused about how a general surgeon might get involved in such a vocation. This musing involved several proposals for procedures that a general surgeon would have within his skill set to do if requeste...

A Doctor Can Finally Tell Fresenius: ‘I Told You So’

Pharmalot — Wed, 20 Feb 2013 13:28:00 +0100

Last year, we wrote that Fresenius Kabi got into a tussle with a Danish professor after he and several colleagues published a paper in The New England Journal of Medicine that concluded its hydroxyethyl starch treatment for sepsis may cause kidney failure and hemorrhages that may lead to patient death. The drugmaker reportedly threatened a lawsuit after the professor told ScienceNordic the treatment should not be used for sepsis (back story). The spat between the drugmaker and the professor may not have normally generated much notice had the spector of litigation not been raised. Although Fresenius later denied threatening litigation, the possibility that the drugmaker may have been willing to file a lawsuit raised concerns over academic freedom and drew greater attention to the findings a...

Medicare Costs Rise as Knee Replacements Increase for Seniors

Lab Soft News — Mon, 18 Feb 2013 18:47:55 +0100

A portion of the financial challenge facing Medicare is the soaring cost of healthcare delivery in general. Another specific factor is the increasing cost of care for older patients who are covered by the program. One good example of this is knee arthroplasty for seniors on Medicare. This idea was detailed in a recent article (see: Medicare knee replacements surge 162% since 1991). Below is an excerpt from it: The popularity of total knee arthroplasty surgeries among Medicare patients has grown considerably as beneficiaries are living longer and seeking to increase their mobility, but the shift has led to fiscal concerns for the entitlement program....Overall volume growth has been driven both by the increased number of Medicare enrollees and by increased per capita utilization....Th...

The LITFL Review 095

Life in the Fast Lane — Mon, 18 Feb 2013 07:21:02 +0100

Welcome to the challenging 95th edition! The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around. The Most Fair Dinkum Ripper Beaut of the Week emimdoc Top spot this week heads over to David at emimdoc with his post on A Note to Conference Organizers Everywhere. David highlights how FOAMed has changed the way we access and engage in conference’s and how conference organisers need to keep up with realms of ...

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R&R in the FASTLANE 029

Life in the Fast Lane — Fri, 15 Feb 2013 06:38:27 +0100

Having been away for a few months due to the distractions of SMACC, moving across a continent and an untold number of other side projects, our series of eminence-based evidence is back with the 29th edition: A free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains 8 recommended reads. Find out more about the R&R in the FASTLANE project here and check out the team of contributors from all around the world. This edition’s R&R Hall of Famer Abdo WF, Heunks LM. Oxygen-induced hypercapnia in COPD: myths and facts. Crit Care. 2012 Oct 29;16(5):323. [Epub ahead of print] PubMed PMI...

Mending

WhiteCoat's Call Room — Fri, 15 Feb 2013 00:26:57 +0100

Surgery went uneventfully, I think. Don’t remember much of it because of the dang Versed. While walking back to the outpatient surgery room, I never thought what big business surgeries are for hospitals. The outpatient surgery floor had a long curving hallway of identical rooms, one after another, all with freshly-made beds, blankets folded neatly on top of the beds, and patient belonging bags draped over the blankets. Walking by the rooms, it was almost like having the same picture flashed in front of my face over and over again. After I got settled in the room and started watching the news on the flat screen TV in the room, a rapid-fire succession of people came in and out of the room … nurse, nurse anesthetist, anesthesiologist, OR nurse, then surgeon. I could hear them goin...

CADD-Solis VIP Ambulatory Infusion System Gets U.S. Green Light

Medgadget — Thu, 14 Feb 2013 15:20:26 +0100

Smiths Medical received FDA clearance for its CADD-Solis VIP ambulatory infusion system, a smart pump and accompanying software that prevents errors in medication delivery for both adult and pediatric patients. Predefined limits are set on the pump so that operators that load drugs and set delivery parameters don’t accidentally go beyond those limits due to dose misinterpretations and keypad programming errors. More from Smiths Medical:Administrator software is a Windows® based application used by select staff members to create and manage the standardized pump protocols. The application is used to securely and accurately program the CADD®-Solis VIP pump saving Pharmacist and Nursing time in manually programming the infusion pump. Infusion data is collected for additional pump docum...

Sherpa Pak Transplant Heart Transport System Gets U.S. Green Light

Medgadget — Wed, 13 Feb 2013 20:11:20 +0100

Paragonix Technologies out of Cambridge, Massachusetts received clearance in the U.S. for the Sherpa Pak Cardiac Transport System. The Sherpa combines oxygenated perfusion of organs and safe organ storage. The device is indicated for hypothermic transportation of hearts in a cold environment for up to four hours in preparation for a transplant. From the announcement:Currently, the availability of cardiac transplantation is governed by the “ischemic time”, that being, the elapsed time from heart donation to recipient implantation. According to The International Society Of Heart and Lung Transplantation (“ISHLT”) guidelines(2) for the care of heart transplant recipients, the projected ischemic time should not exceed 4 hours(3,4), limiting the distance available to t...

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The LITFL Review 094

Life in the Fast Lane — Tue, 12 Feb 2013 03:00:46 +0100

Welcome to the awesome 94th edition! The LITFL Review is your regular and reliable source for the highest highlights, sneakiest sneak peaks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the best and brightest from the blogosphere, the podcast video/audiosphere and the rest of the Web 2.0 social media jungle to find the most fantastic EM/CC FOAM (Free Open Access Meducation) around. The Most Fair Dinkum Ripper Beaut of the Week StEmylns Top spot this week has been smashed by two great post from the StEmylns team! First up we have Simon as he prepares us for the ever dreaded Perimortem C-section - what other procedure can deliver a 200% mortality? This post is brilliant, in depth and covers both th...

Dash 22

Buckeye Surgeon — Sun, 10 Feb 2013 05:00:00 +0100

The consult came in around 3:30 on a Friday. The surgeon wasn't on call but his partner was tied up and he, the surgeon, felt obligated to see the new patient before it got too late. To do otherwise is known as a "dick move" in the world of small private surgical practice. The computer record outlined the picture of a man in his late seventies with an unremarkable medical history. He only took something for gout and various other over the counter vitamins. He took something called Life-X 3000. The consult request was "evaluate for gallbladder disease". The patient had been admitted three days prior. That was interesting. The admitting diagnosis was "diarrhea". The surgeon perused the completed blood work and i...

Allied Health Careers without a Degree: Anesthesia Technician

Medical Coding and Billing Blogspot — Sun, 10 Feb 2013 05:00:00 +0100

Becoming an anesthesia technician doesn't take long at all. Training is available through vocational training institutions, community, or junior college and usually ends with a certificate/diploma. The median salary for an anesthesia technician is $34,304. http://alliedhealthcareer.com/Diplomas/anesthesia_technician.html (Source: Medical Coding and Billing Blogspot)

Dear Diary

WhiteCoat's Call Room — Fri, 08 Feb 2013 02:46:34 +0100

Well, I thought we escaped it, but we didn’t. The past week has been full of emesis, diarrhea, and disinfectant spray. Just when we think that things are on the mend, someone else in the family starts having a stomach ache. The vomiting is the worst. When it starts out, it sounds like a loud belch … until you hear the progression of the sounds. Yeah. Too much information. But on a good note, I have seen that my kids are immune to boredom. They were able to watch the same episodes of Disney sit-coms a half dozen times and still got mad when I turned off the television. I’ve cut back on my work hours a little which gives me some extra time to hang out with Mrs. WhiteCoat and the kids. Kind of fun taking a morning to walk through the mall or going to lunch and catching a mat...

What are the different types of anesthesia?

Kevin, M.D. - Medical Weblog — Tue, 05 Feb 2013 18:00:00 +0100

For most people, anesthesia is one of the more mysterious branches of medicine. What we do for patients is done, generally, when they are asleep. You the patient don’t exactly know what we are going to do, or how it’s done, but you put yourselves in our hands willingly. It’s sort of a weird relationship we have with other humans. We have done our job right if our patients don’t remember most of what we did.Continue reading ... Manage your online reputation: A complete social media guide. Read the book by KevinMD. (Source: Kevin, M.D. - Medical Weblog)

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Suicide Docs

Buckeye Surgeon — Sun, 03 Feb 2013 05:00:00 +0100

From the Economist in October 2012 was an article on physician assisted suicide. In the United States, terminally ill patients can apply for permission to end their lives with the guidance of a doctor in Oregon and Washington state. Several safeguards are in place to prevent this from becoming the default death pathway (only 0.2% of total Oregonian deaths). Also, I had no idea that Holland, Switzerland, and Belgium allow assisted suicide even in non-terminally ill citizens. So you can be suffering from, say, severe acne vulgaris, in the Netherlands and be within your rights to seek immediate death from a certified death-administering professional. Revelatory, indeed. And heartwarming to read about on a Sunday. M...

Anesthesia awareness: Look beyond the headlines

Kevin, M.D. - Medical Weblog — Fri, 01 Feb 2013 00:00:22 +0100

Don’t be surprised if patients start asking more questions than usual about awareness under anesthesia. We can all thank a recent article in The Atlantic magazine, with a large-print headline on the cover: “Awake Under the Knife”. Written by a UCSF medical student in preclinical training, the article not only assures everyone that awareness can happen, but takes pains to point out that anesthesiologists can’t always prevent it.Continue reading ... Read KevinMD's book: Establishing, Managing and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices. (Source: Kevin, M.D. - Medical Weblog)

Layers of Nonsense

Buckeye Surgeon — Thu, 31 Jan 2013 05:00:00 +0100

Wrong site surgery is never acceptable. A surgeon ought never to find himself in a situation where he has to inform the family that he just operated on the wrong body part. It is embarrassing, unprofessional, and an egregious violation of the patient/physician covenant. That being said, we have allowed this issue to be defined entirely in terms of "systems management". And hence the rise of the Time-out and the Checklist. The ultimate responsibility for identifying the proper surgical site has been diluted. No longer is it at the sole discretion of the operating surgeon. Now we have a Team-Based approach involving nurses, anesthesia personnel, mid level providers, and surgeons. Performance of a group time out (of w...

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i'm so sleepy — Tue, 29 Jan 2013 13:21:00 +0100

It's going to be a banner day when the anesthesiologist is the most qualified person in the room to put in the Foley catheter. (Source: i'm so sleepy)

Study Identifies Itch-specific Nerves

Highlight HEALTH — Tue, 29 Jan 2013 04:40:59 +0100

Scientists have been looking for itch-specific nerves for decades. New research from investigators at Johns Hopkins University and Yale University in the United States and several universities in China has identified sensory neurons in mice that are dedicated to relaying itchy sensations from the top layers of skin to the spinal cord [1]. In 1835, Johannes Peter Müller proposed the law of specific nerve energies. It stated that everything we feel and experience relies on the stimulation of particular neuronal pathways — and thus that the actual, external stimulus is irrelevant. He wrote: The same cause, such as electricity, can simultaneously affect all sensory organs, since they are all sensitive to it; and yet, every sensory nerve reacts to it differently; one nerve perceives i...

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The Next Generation of Doctors – #HITsm Chat Highlights

EMR and HIPAA — Mon, 28 Jan 2013 04:21:01 +0100

The theme for today’s chat was “The Next Generation of Doctors.” When I read this, I wasn’t sure what to expect. It definitely sounded like an interesting topic, and it proved to be one. Here are the questions that were asked, and some of my favorite responses: Topic One: Who are the emerging leaders you admire for their ideas in shaping the future of medicine? Why? Share resources! T1: A leader I admire is @erictopol as he is showing the way to a new personal healthcare & how to do it. Vision + Practical Use. #HITsm — Jon Mertz (@jonmertz) January 25, 2013 T1: I’m pretty inspired by the efforts of @neel_shah and his work founding @costsofcare. Neel was a moderator of a chat last year.#HITsm — Chad Johnson (@OchoTex) January 25, 2013 t1 – to...

All you wanted to know about embryo transfer

The Patient's Doctor — Mon, 28 Jan 2013 02:01:00 +0100

The day when our in-vitro embryos return back to us (to their mama !) is one of the most exciting moments of an IVF cycle. We forget the struggles we went through when we are admiring our microscopic babies under the microscope. Embryo transfer is one of the rate-limiting steps in an IVF cycle and plays a pivotal role in determining IVF success. Since the invention of IVF, major developments have been made in ovarian stimulation protocols; the way oocytes are collected ; and in the IVF lab; but the embryo transfer method remains largely unchanged. Embryo transfer done badly by an inexperienced doctor can change the fate of an IVF cycle –there is a vital intangible “physician factor” involved in determining the outcome of an IVF cycle! When different individuals perform emb...

Have things changed? Would you force them to?

Running a hospital — Sun, 27 Jan 2013 23:56:00 +0100

I want to provide a description of a hospital and ask you whether it might apply to a place in which you work. Later, I'll tell you the source, and I will also present some questions to you. I hope you will submit your answers as comments.A clinician-management divide; an excessively devolved system of management; an oral culture; a commitment to turning questions back on the questioner. A concentration of power combined with a fragmentation of responsibility. This militated against the provision of an adequate standard of care. Early warning signals of problems were less likely to be picked up if the care provided by some unit of the organisation were to become less than adequate.The clinical directorates became isolated from each other. The development of `silos', channelling...

BehindTheMedspeak: On overcoming the fear you're killing someone by inducing anesthesia during your first week of residency

bookofjoe — Fri, 25 Jan 2013 05:00:00 +0100

(Source: bookofjoe)

Network Numbness

InsureBlog — Wed, 23 Jan 2013 18:30:00 +0100

From email I received this morning:"Kettering Anesthesia Associates, which serves [various providers in the Dayton, OH area], has chosen to terminate its provider contract with Anthem ... Consequently, Anthem members may be billed by Kettering Anesthesia Associates for any balance not covered by Anthem"This is SOP when dealing with network-based plans: with some exceptions, providers are barred from "balance billing" their patients for amounts written off as discounts. The big problem here is that PARE providers generally have an exclusive relationship with hospitals; that is, if you're going to be "put under" at (for example) Kettering Hospital, you don't have a choice of gas-passers. If they're not in-network, they can bill you pretty much anything they want, and you're on the hook...

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Why your nurse practitioner is your friend

Kevin, M.D. - Medical Weblog — Tue, 22 Jan 2013 20:00:49 +0100

A recent editorial in the New York Times about non-physician health care providers or NPPs, has drawn more than 260 comments. Who are these NPPs and why do so many people care about them?Historically, nurses have a long history of stepping in when there are gaps. For example, in the early 1900s anesthesia was given by med students and interns and everybody was unhappy, until nurses started doing it full-time, and then the surgeons were much happier. When surgeons are happy, everyone is happy, I’ll tell you that for free.Continue reading ... Follow KevinMD.com on Facebook, Twitter, Google+, and LinkedIn. (Source: Kevin, M.D. - Medical Weblog)

From the Heart of my Bottom

The Patient's Doctor — Tue, 22 Jan 2013 14:16:00 +0100

This is a guest post from Dr Kishore Shah of Pune - and proves that doctors have a sense of humour too ! -----------It was a very painful decision, but it had to be taken. Yes! I needed a haemorrhoidectomy. I had reached the ‘bottom’ of the barrel of excuses and could not put it off any longer.But who was going to get the honour of seeing my bottom? At that time, there were three surgical bosses, Dr. Trivedi, Dr. Narang and Dr. Belokar. All of them were competent and proficient in their own ways. It was a difficult choice.Dr. Belokar had a very typical way of examining patients. If there was a large hydrocoele, he would caress it lovingly and exclaim, “Wonderful!!!!!” I winced at the imagined picture of him caressing my bottom and saying ‘Wonderful!’I decided that the best jud...

Need help determining what to do next.

Med Student Guide — Sat, 19 Jan 2013 07:31:00 +0100

by etopn23 (Posted Sat Jan 19, 2013 2:31 am)Well, where should I start?I left high school feeling like I was on top of the world. Great grades had always come easily to me, and I assumed that post-high school education would be more of the same. I was admitted to Baylor University in Waco and was supposed to begin pursuing my childhood dream of becoming a doctor. Instead, I fought bouts of depression and disenlightenment. I stopped attending classes the second semester of my freshman year, was put on academic probation, and decided to leave the institution. I questioned whether medicine was the path for me; I felt that I lacked the determination to become a doctor.I decided to attend the local community college for a year while I gathered my thoughts; that year culminated with my acceptanc...

A Short Rise Out of Depression

In the Pipeline — Fri, 18 Jan 2013 12:53:23 +0100

Here's another one to file under "What we don't know about brain chemistry". That's a roomy category for sure, which (to be optimistic about it) leaves a lot of room for discovery. In that category are the observations that ketamine seems to dramatically help some people with major depression. It's an old drug, of course, still used in some situations as an anesthetic, and also used (or abused) by people who wish to deliberately derange themselves in dance clubs. Chemists will note the chemical resemblance to phencyclidine (PCP), a compound whose reputation for causing derangement is thouroughly deserved. (Ketamine was, in fact, a "second-generation" version of PCP, many years on). Both of these compounds are, among other things, NMDA receptor antagonists. That had not been considered a h...

4 fixes that will boost your bottom line

hospital impact — Thu, 17 Jan 2013 23:40:02 +0100

by Kenneth H. Cohn Happy New Year. Sometimes, the fuss in Washington causes temporary amnesia that healthcare, like politics, has a local focus. So this post contains the first four tips on ways to engage physicians where you work to improve clinical and financial outcomes and create a more satisfying practice environment: 1. Convene a panel of your top physicians to look at how improved collaboration can reduce expenses. A surgeon once confessed to me, "I may ignore others' opinions, but I definitely listen to physicians who refer patients to me or to whom I refer patients for preoperative clearance and postoperative management." Take, for example, a CEO at a Rocky Mountain tertiary care facility who asked the Medical Advisory Panel at his hospital for advice on how to cut supply co...

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Ingestible Pill Provides 3D View of the Esophagus (w/video)

Medgadget — Wed, 16 Jan 2013 19:57:24 +0100

Researchers at the Massachusetts General Hospital in Boston have developed a tethered, pill-sized endoscope that provides cross-sectional and three-dimensional microstructural images of the upper gastrointestinal tract. The procedure requires minimal training, does not need anesthesia and is pain-free. The patient swallows the clear plastic pill with a cup of water, after which it can be moved up and down the esophagus to capture images using the attached wire.The device works via optical frequency domain imaging, using a beam of infrared light which is split into two with mirrors. One beam is used as a reference; the other is sent through the tether, into the pill, where it is directed into the tissue. The beam spins around the pill’s axis 20 times per second and the signal of the r...

Defense & Veterans Center for Integrative Pain Management (DVCIPM)

Psychology of Pain — Wed, 16 Jan 2013 13:47:00 +0100

Established in 2003, the Army Regional Anesthesia & Pain Management Initiative (ARAPMI) sought to improve the management of acute pain in military and civilian medicine. Through clinical research efforts, it has become the model of integrated acute and chronic pain medicine. During the next six years, the ARAPMI vision expanded exponentially and now encompasses all aspects of pain management beginning at point of injury, regardless of where the injury occurs (battlefield, training or motor vehicle accident). The organizational objective expanded to ensure that pain management services are available at all military treatment facilities, those in-theatre, in Germany, and throughout the continental United States. A collaborative working relationship with Navy, Air Force and Veterans Admi...

When patients demand a brand-name drug, many doctors likely to give in

Consumer Reports Health Blog — Mon, 14 Jan 2013 18:15:05 +0100

If you ask your doctor for a brand-name drug, there's a good chance he or she will comply, even if there's a cheaper, equally effective generic drug available. That's especially true if your doctor is older, works in a small practice, or, big surprise, frequently has visits from drug representatives. The new survey, published last week in the journal JAMA Internal Medicine, found that two-thirds of doctors said that they never or rarely prescribed a brand-name drug instead of an equivalent generic simply because of a patient request. But doctors who had visits from industry reps were more likely to do so, particularly if they came bearing goodies, like free food or drug samples. In addition, 43 percent of physicians in practice for 30 years or longer were likely to give in to patients' r...

The surgery gods can be your best friend or your worst enemy

Kevin, M.D. - Medical Weblog — Sun, 13 Jan 2013 20:00:15 +0100

“Will this case take very long?”“If the surgery gods are with me we should be done in an hour.”The above brief exchange took place between me and the anesthesiologist attending to my patient on a recent surgery. The patient was a middle aged woman who was about to undergo surgery to relieve a small bowel obstruction. She had been visiting her husband in a distant city where he was working and had become ill. She was hospitalized and after several days of testing surgery was recommended. Her husband was reluctant for her to undergo a major operation in a city far away from home and their regular doctors.Continue reading ... Follow KevinMD.com on Facebook, Twitter, Google+, and LinkedIn. (Source: Kevin, M.D. - Medical Weblog)

RN to MD. Is this possible?

Med Student Guide — Sat, 12 Jan 2013 22:19:00 +0100

by Enot (Posted Sat Jan 12, 2013 5:19 pm)http://www.nrmp.org/data/index.htmlIf you are curious about how competitive you might be, you can search to find an site that will correlate your MCAT score to a Step 1 score, and then you can compare the graph on the link above to your projected score. THere is also a score comparison tool on this website. I think it is found under "medical students". Anesthesia is moderately competitive, looking at this, board scores seem to be just above average. By Trauma, I assume you mean surgery. General surgery is a competitive residency. Cardiology is a subspecialty of the general specialty of internal medicine, which is also moderately competitive. Critical care is also a subspecialty of IM. Going to medical schools that are connected to large metropolita...

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Fatally Ill, and Making Herself the Lesson - NYTimes.com

Psychology of Pain — Sat, 12 Jan 2013 01:00:00 +0100

It was early November when Martha Keochareon called the nursing school at Holyoke Community College, her alma mater. She had a proposal, which she laid out in a voice mail message."I have cancer," she said after introducing herself, "and I'm wondering if you'll need somebody to do a case study on, a hospice patient."Perhaps some nursing students "just want to feel what a tumor feels like," she went on. Or they could learn something about hospice care, which aims to help terminally ill people die comfortably at home."Maybe you'll have some ambitious student that wants to do a project," Ms. Keochareon (pronounced CATCH-uron) said after leaving her phone number. "Thank you. Bye."Kelly Keane, a counselor at the college who received the message, was instantly intrigued. Holyoke's nursing s...

Value Cases for Clinical Documentation Improvement

Life as a Healthcare CIO — Wed, 09 Jan 2013 11:00:00 +0100

As BIDMC prepares for ICD10, we're examining the entire clinical documentation process and asking how best to leverage the work we must do to support ICD10 with the innovations we believe will transform our workflow.As mentioned in a previous post, we're working with several innovators to re-examine assumptions we made for decades about clinical documentation.Here's an analysis of the types of projects we could do, the challenges, and the proposals, stratified into documentation improvement, structured documentation, code capture, validation, billing, and audit/review categories. Imagine the following workflow:An orthopedist sees a patient for a hip fracture and writes a comprehensive note using a fracture specific template to capture a combination of structured and unstructured data...

Which Docs Prescribe More Expensive Meds?

Pharmalot — Tue, 08 Jan 2013 13:30:05 +0100

Nag, and you shall receive. That is the take-away message from a national survey of nearly 1,900 physicians in which 43 percent in practice more than 30 years acknowledged that they sometimes or often accede to patient demands for brand-name drugs. By comparison, 31 percent of physicians in practice for 10 years or less gave in. Overall, 37 percent of docs cave in to patient nagging. Among the various specialties, pediatricians, anesthesiologists, cardiologists and general surgeons were significantly less likely to acquiesce relative to internal medicine docs. And those working primarily in solo or two-person practices were significantly more likely to give in than those working in a hospital or medical school – 46 percent % vs 35 percent. The findings were published this week in a r...

It’s time to stop being afraid to study gun violence

Kevin, M.D. - Medical Weblog — Sun, 06 Jan 2013 20:00:18 +0100

A new message pops up on my phone. I signal to the attending and step out of the OR. I’m on anesthesia rotation at Santa Clara Valley Medical Center, as a pediatrics resident at Lucile Packard Children’s Hospital at Stanford. But because I’m also a mom to a first grader in Cupertino, both my pager and my cell phone are frequently “on call”.“I want to take this opportunity to update you about the police activity at Monta Vista High School this morning.”My heart skips a beat.Continue reading ... Follow KevinMD.com on Facebook, Twitter, Google+, and LinkedIn. (Source: Kevin, M.D. - Medical Weblog)

TL-300 Tablet Based Non-Invasive Hemodynamic Monitoring System Soon Available in U.S.

Medgadget — Fri, 04 Jan 2013 20:30:26 +0100

Tensys Medical (San Diego, CA) received FDA 510(k) clearance for its latest non-invasive hemodynamic monitor in its T-Line of products, the TL-300. Just like the other devices in the product line, the TL-300 does continuous beat-to-beat waveform and blood pressure monitoring, but seems to use what looks like an iPad as its interface. From Tensys:In addition to continuous beat-to-beat blood pressure and arterial waveform, the operator is readily able to view trend data for up to a 12-hour period. The tablet displays data coming from an integrated bracelet, sensor, and wrist frame placed over the patient’s radial artery. The wrist frame is disposed at the end of the case and the bracelet and sensor are immediately available for the next patient. Today, the T-line family is used in a numb...

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RN to MD. Is this possible?

Med Student Guide — Fri, 04 Jan 2013 18:13:00 +0100

by candicen (Posted Fri Jan 04, 2013 1:13 pm)Thank a lot for your response.Other questions I want to ask are: I am considering Cardiology, Trauma, Critical Care, and Anesthesiology. How competitive is it to get into a residency for one of these areas? I am trying to do research on medical schools, and I wonder if going to a particular medical school will have an impact on whether I will get into one of these specialty. In addition, how did you and when did you start doing research on medical schools? I am trying to start now and it is almost impossible to do without MCAT score.Sorry for asking lot of questions. I want to find out as much as possible. Medical school is rough:) (Source: Med Student Guide)

Multiple Sclerosis Out Of Body Experience

Life with MS — Fri, 04 Jan 2013 17:41:54 +0100

Sometimes MS can do things to our bodies that make us wish we could just check out of them for a little while. Other times, however, I find myself a few feet away and it freaks me out! It happens most often if I am sitting and typing at my laptop for a while. Not all of the time; not even much of the time. This sensation only comes over me as an MS “thing” is about to happen (or is already underway). I get the sense that I am somehow about six inches behind and about three inches above my body. I almost want to reach out further in order to touch the keys as the feeling is so strong and so real. This stretch in consciousness is usually accompanied with a tunneling in my sense of hearing as if my brain is that same distance behind my ears. I can move my head around a bit and shake the ...

American Academy of Pain Medicine Incoming President Asks for Pain: Without Industry Involvement - Where Will the Education and Research Funds Come From?

Policy and Medicine — Fri, 04 Jan 2013 05:00:00 +0100

According to a recent article from Anesthesiology News, “The U.S. Senate Finance Committee is set to complete their investigation into the extent and implications of financial ties between the manufacturers of pain-relieving opioid drugs and professional pain societies, including the American Academy of Pain Medicine (AAPM).” As we noted back in May of this year, the Senate sent letters to several pharmaceutical companies and professional medical associations regarding their relationships. According to the article, written by Lynn Webster, MD, incoming president of the AAPM, the Committee will be investigating “the amount of money provided to professional societies to create and deliver educational content on how to prescribe and consume opioid medications.” The two sena...

Link feast

BPS RESEARCH DIGEST — Fri, 04 Jan 2013 05:00:00 +0100

In case you missed them - 10 of the best psychology links from the past week (or so): 1. Atlantic published a truly dazzling long-form feature about anaesthesia and consciousness, including instances when people wake during surgery, and the on-going attempts to build a machine that can somehow measure the level of a person's awareness (their consciousness). (see also). 2. Bang in the middle of the Xmas and New Year festivities, BBC Radio Four broadcast a timely special edition of its Thinking Allowed programme all about intoxication (now on iPlayer). 3. It's never too late to learn a new skill, says Gary Marcus in an up-beat essay for the New Yorker. 4. Vaughan Bell for The Observer wrote a column arguing that violent video games are unlikely to be the catalyst for ...

American Academy of Pain Medicine Incoming President Asks: Without Industry Involvement - Where Will the Education and Research Funds Come From?

Policy and Medicine — Fri, 04 Jan 2013 05:00:00 +0100

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Grading the Fiscal Cliff Deal: Terrible, but Could Be Worse

Cato-at-liberty — Wed, 02 Jan 2013 14:15:00 +0100

Daniel J. Mitchell The faux drama in Washington is finally over. The misfits in Washington reached a deal on the fiscal cliff. Republicans and Democrats managed to come together and decide that they should get a bigger slice of what the American people earn. Gee, what a surprise. First, the good news: … … Oh, wait, there isn’t any. Now for the bad news. The top tax rate will increase to 39.6 percent for entrepreneurs, investors, small business owners, and other “rich” taxpayers making more than $400,000 ($450,000 for married couples). This is Obama’s big victory. He gets his class-warfare trophy. The double tax on dividends and capital gains climbs from 15 percent to 20 percent (23.8 percent if you include the Obamacare tax on investment income). The death tax ra...

New Academic Year Thoughts

Nurse Anesthetist — Sat, 29 Dec 2012 20:42:25 +0100

The academic year is well underway and thoughts now turn to the candidates that will be filing applications for graduate nurse anesthetists programs. For those that are thinking about or are applying this year here are a few tips from someone fresh in the mix. Dear David, Words cannot express the gratitude that I have for the invaluable shadow experience you presented me and all the words of encouragement you provided me. Forgive my redundancy, but thank you, thank you, thank you, thank you and thank you some more. My journey to become a CRNA started when I was just in my third semester of nursing school. During my clinical as a nursing student in the OR I approached a CRNA and his SRNA apprentice. I asked them “What do I need to do to be a CRNA?” To my surprise they kindly...

THE Critical Care conference of 2013?

impactEDnurse — Fri, 28 Dec 2012 00:56:08 +0100

The medical social media stream is abuzz right now with the approach of the SMACC conference in Sydney this March. SMACC stands for Social Media and Critical Care. It promises to be a dynamic event with some really quality content. With its savvy integration of social media and traditional presentation formats it may well be a tipping point in future medical conference architecture. I have no doubt plenty of other conference organisers will be watching with interest. If you are a nurse working in the critical care specialty, this conference is definitely one to start tracking towards. Get onto your unit managers, apply for conference leave and hook into any funding opportunities your hospital may provide (You might be surprised at the options that are available to financially assist you he...

TechTool Thursday 011

Life in the Fast Lane — Thu, 27 Dec 2012 10:02:37 +0100

TechTool review of palmPEDi by palmER Worldwide LLC on iOS (reviewed on iPhone) Website: – iTunes - Website palmPEDi provides quick access to important drug doses for paediatric emergencies. It’s all done by weight (or an estimated weight based on age). Select the weight and a long list of drug doses are at your feet (fingertips) Design and User Interface The overall UI is simple but clear. I’m not sure why they have added coloured blocks to the left of each row in the main screen. This is confusing (to me anyway) and also cheapens the look of the app – they’d be better off just removing the colour coding and keeping it all black/grey. EDIT: Colours correspond to the Broselow tape as has been pointed out by 2 astute readers (Ben Beuchler and EJ). Still t...

Protect Your Children – The AAP and WHO Want to Keep Poisonous Mercury in Vaccines

vactruth.com — Sun, 23 Dec 2012 05:02:29 +0100

Doctors and health officials are protesting taking thimerosal, a neurotoxic vaccine ingredient, out of vaccines. We know that mercury is a toxin. We know that it was removed from most vaccines more than a decade ago. End of story, right? Wrong. The debate has resurfaced. If the AAP and the WHO have their way and can successfully influence the United Nations Environmental Program (UNEP), some vaccines will still contain thimerosal. The UNEP, as part of an effort to reduce mercury exposure, is considering banning thimerosal worldwide. The AAP and the WHO’s Strategic Advisory Group of Experts (SAGE) on Immunization are asking the UN to reconsider. Their statements are included in the online version of the January issue of Pediatrics. Although you can’t read the article without purchasing ...

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The unsung heroes of modern medicine

Caroline's Breast Cancer Blog — Sat, 22 Dec 2012 14:06:00 +0100

This article made me remember them all. We shoudl take a moment to thank them all. (Source: Caroline's Breast Cancer Blog)

FOAM Procedure Video Database

Life in the Fast Lane — Fri, 21 Dec 2012 03:44:07 +0100

I know, I know – I’ve been told. “Nickson, why are you slacking off, there have been bugger all posts by you the last month or so.” Hey, I’ve been busy. First up, I’ve finally got around to putting a collection of FOAM videos of emergency medicine and critical care procedures from around the web online in one searchable database. The database lives on the LITFL Procedures page (down the bottom of the Education drop down menu on the LITFL website task bar). I’ve reproduced it here so you can have a play with it. SectionTitleKeyWordsAuthorLink airwayInserting an OPAOPA, oropharyngeal airway, ACLSemtfiretrainingVIDEO airwayInserting a NPANPA, nasopharyngeal airway, ACLSemtfiretrainingVIDEO airwaySuctioning the airwaySuctioni...

Thank FFFF It’s Christmas

Life in the Fast Lane — Fri, 21 Dec 2012 01:30:18 +0100

Draw near, and gather round the FFFFire for this very Christmas edition of Funtabulous medical trivia. This year we celebrate the 12 days of Christmas in ER with an eclectic collection of 12 festive related questions to amuse and bemuse…. …but first – a word from our sponsor http://www.youtube.com/watch?v=iIxhXHds20I Question 1 Which of the following are known to have engaged in parthenogenesis? The New Mexico Whiptail lizard The domesticated honey bee The water flea Daphnia pulex The blessed virgin Mary All of the above Reveal the funtabulous answer! expand(document.getElementById('ddet634787584'));expand(document.getElementById('ddetlink634787584')) All of the Above Parthenogenesis is a form of asexual reproduction in which growth and development of embryos occur...

Another Good Reason to Quit Smoking in New Year: Less Back Pain - University of Rochester Medical Center

Psychology of Pain — Thu, 20 Dec 2012 23:48:00 +0100

A University of Rochester Medical Center analysis of more than 5,300 patients followed for eight months during treatment of spinal disorders showed that cigarette smokers reported far more pain than never-smokers or those who had quit.Smoking cessation either prior to treatment or during the course of care was related to significant improvements in pain – a result that underlines the need for structured stop-smoking programs among the legions of patients who experience back pain due to degenerative disease, deformity, or musculoskeletal problems, said Caleb Behrend, M.D., chief resident in the Department of Orthopaedics and Rehabilitation at URMC.Glenn R. Rechtine, M.D., a nationally recognized spinal surgeon and adjunct faculty at URMC, led the study, which was publi...

The Story Behind ‘Catfish’

World of Psychology — Thu, 20 Dec 2012 11:24:14 +0100

“To think about the definition of ‘Catfish,’ it’s really anybody that is willing to take a risk, push the envelope, leave their comfort zone.” ~ Nev Shulman Nev Shulman, a 20-something photographer from New York City, was heartbroken to discover that the girl he was falling for online was actually a disturbed, middle-aged mother who took on the role of several false personas. Catfish, the 2010 documentary that featured Nev’s journey, encouraged others to share stories of their own. “Catfish,” the television show, debuted this past November on MTV; Nev and his filmmaker friend, Max Joseph, travel around the country to help those involved in online relationships meet face-to face. The catch? They all hope that the person they’ve emotionally invested in is who they say they...

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When a hospital corridor becomes a nature trail.

impactEDnurse — Thu, 20 Dec 2012 06:41:12 +0100

Meanwhile, over on Nurse+, Ellen Richter pointed us to an interactive hospital corridor artwork installed in Ormond Street Hospital. LED panels (and a total of 72,000 LED’s) have been embedded into the wall surface to provide a series of animated animals moving through the forrest foliage. If you cannot see the player above here is a link to the video The brief was to design and install a distraction artwork helping to create a calming yet engaging route that culminates in the patient’s arrival at the anaesthetic room. Inspiration came from the idea of viewing the patient journey as a ‘Nature Trail’, where the hospital walls become the natural canvas, with digital look out points that reveal the various ‘forest creatures’, including horses, deer, hedgehogs, birds and frogs, t...

Post-Operative Pain in Suboxone Patients

Suboxone Talk Zone — Wed, 19 Dec 2012 16:12:17 +0100

I’ve written about this topic a number of times, but I continue to receive emails from people on buprenorphine who describe inadequate pain control following surgery. I have prepared a document for my own patients to provide to surgeons, dentists, and ER staff to be used in the case of injury or surgery. A copy of that document can be found [...] (Source: Suboxone Talk Zone)

Prescription Drug Shortages: Crisis Abating - Still Need for Pricing Reform

Policy and Medicine — Wed, 19 Dec 2012 05:00:00 +0100

Some progress on drug shortages has been made over the last few months, due in part to manufacturing improvements. For example, Genzyme said that a new plant was now producing all of the supply needed for its thyroid cancer treatment, Thyrogen. Supply had been spotty for about three years, but now biotech unit of Sanofi says it is producing enough of the drug to meet the needs of all patients. “We are grateful to the thyroid cancer treatment community for its ongoing patience and partnership,” Alicia Secor, Genzyme’s vice president and general manager of endocrinology, said in a statement. A Genzyme spokeswoman explained in an email that the drug went onto shortage lists as Genzyme worked through manufacturing problems after a virus was found at the Boston-area plant where t...

Greek Healthcare - compare with France

PharmaGossip — Mon, 17 Dec 2012 05:00:00 +0100

No chemotherapy for Greeks without cash Anthina is struggling to stand. "She's so hungry, she's feeling dizzy," said Elena Bazakopoulou. She kneels down next to the small girl and hands her some sweets. "Just sit down for a bit and hold the dolls," Elena suggests. Anthina visibly relaxes when Elena starts asking her about school and her six siblings. The previous day, the family's water supply was turned off after they had been unable to pay the bills. But that's not even their biggest worry: Anthina's brother has a heart condition and his mother is at the "Metropolitan Social Clinic" for help. The clinic, in a former American military base, is located in Ellinikon, one of Athens' southern suburbs. Poor, unemployed - and sick The clinic was founded a year ago by the cardiologist Giorg...