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Treating Chest Pain With a Cup of Tea
By ANISH KOKA, MD It is very early.  I am running to the ‘clinical decision unit’ (CDU) to see a patient of mine sent in the night before from a local skilled nursing facility.  Also known as clinical observation units,  ‘obs’ units, or short stay observation units, these units were designed to help decompress busy emergency rooms and divert unnecessary, expensive inpatient admissions.  The units are typically adjacent to emergency departments, and usually are run by emergency physicians. My particular patient was admitted due to an episode of chest pain at her facility.  A brief conversation t...
Source: The Health Care Blog - January 9, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized CCTA Chest Pain EHR Source Type: blogs

Code Name: AvicennaThe Future In Progress
One of my Radiology professors back in residency, a very wise man, had a saying: "The more dogmatic you get, the more likely you will be wrong."In the medical business, there is a tie for the three most important little words: "I was wrong," competes nicely with "I don't know." (If you were wondering, the four scariest words in the radiological lexicon are: "You read a scan...")The Future has a way of sneaking up on us, and occasionally biting us on the behind. In my youth, I thought for example, that age 50 was a long way off. Now I'm well into that decade of life, and the 60's are looming. As Steve Miller put it, "T...
Source: Dalai's PACS Blog - December 4, 2015 Category: Radiology Source Type: blogs

Pleural effusion in heart failure – on which side is it more common?
Brief Review Conventionally it is considered that pleural effusion in heart failure is more common on the right side. If it is bilateral, it is likely to be more severe on the right side. In fact if it is more on the left side, the conventional teaching is that a cause other than heart failure is to be looked for. There have been several discussions on the sidedness of pleural effusion in heart failure one view is that the larger surface area of right lung permits more transudation into the right pleural cavity. Another technical aspect is that an enlarged heart on the left side may prevent the detection of minimal effusio...
Source: Cardiophile MD - November 14, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology heart failure pleural effusion pleural effusion in heart failure Source Type: blogs

I believe , this years Noble economic prize is actually for medical common sense !
This year’s Noble prize for economics was conferred  for Dr Angus Deaton  from Princeton,  for an unique revelation, that measurement errors in economic indices such as estimation of poverty and nutrition levels in society  is real and huge . The crux of argument (My version )  could be , data collection errors , planning with that contaminated data , sets in a chain reaction , that sustain a flawed intellect in young researchers , which  ultimately leads to human beings becoming  victim to their own  data . While Deaton addressed this in economic issues,  one can guess how critical these errors could be , w...
Source: Dr.S.Venkatesan MD - October 21, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Awards in medicine Ethics in Medicine Nobel prize Nobel prize for economics and medicine Source Type: blogs

I believe , this year’s Noble economic prize is actually for medical common sense !
This year’s Noble prize for economics was conferred  for Dr Angus Deaton  from Princeton,  for an unique revelation, that measurement errors in economic indices such as estimation of poverty and nutrition levels in society  is real and huge . The crux of argument (My version )  could be , data collection errors , planning with that contaminated data , sets in a chain reaction , that sustain a flawed intellect in young researchers , which  ultimately leads to human beings becoming  victim to their own  data . While Deaton addressed this in economic issues,  one can guess how critical these errors could be , w...
Source: Dr.S.Venkatesan MD - October 21, 2015 Category: Cardiology Authors: dr s venkatesan Tags: Awards in medicine Ethics in Medicine Nobel prize Nobel prize for economics and medicine Source Type: blogs

If CTO is safe , should we allow all PCI ineligible ATO to evolve as CTO ?
Hot debate in STEMI Acute total obstruction (ATO) of coronary artery is an emergency .Opening it  by pharmacological or catheter is the  standard ( logical ) protocol.However, time plays a crucial role in this coronary re-perfusion game.It can either be a sure shot of success or end up in total spoilsport. One more issue as important as time is from the overflowing scientific data  fired  by different regulators  in conflicting directions  (Also called knowledge) . What to do with STEMI coming late ? ATO with cardiogenic shock is an  absolute emergency at any time. Symptomatic ATO  other than CS beyond 24 hrs stil...
Source: Dr.S.Venkatesan MD - October 20, 2015 Category: Cardiology Authors: dr s venkatesan Tags: acute coroanry syndrome cto chronic total occlusion open artery hypothesis ato vs cto management stemi Source Type: blogs

What Cardiologists Can Teach Economists
By MICHEL ACCAD, MD I had the great fortune and pleasure of studying under the late Kanu Chatterjee during my cardiology fellowship at the University of California San Francisco. In the early 1970’s, Dr. Chatterjee was among the first to understand the benefits of “afterload reduction” for the treatment of congestive heart failure: Prior to that time, giving medications that could lower the blood pressure was often seen as heretical.  In fact, during the 1950’s and 1960’s, the treatment of heart failure sometimes consisted in applying measures to raise the blood pressure and increase the work of the heart. The...
Source: The Health Care Blog - October 14, 2015 Category: Consumer Health News Authors: Simon Nath Tags: THCB MICHEL ACCAD Source Type: blogs

Study Looks At How Many Industry Boards of Directors Have Academic Affiliations
Conflict of interest rules for the medical community have been in the spotlight lately, though they typically center around rules that prohibit or restrict physicians from enjoying lunch on behalf of a pharmaceutical company or stocking their office with pens. A new study conducted by researchers from the University of Pittsburgh School of Medicine and published in the British Medical Journal recently decided to look at conflicts of interest from a different perspective: they looked at how many for-profit healthcare company positions were occupied by people with academic affiliations. These researchers analyzed public disc...
Source: Policy and Medicine - October 7, 2015 Category: American Health Authors: Policy and Medicine Writing Staff Source Type: blogs

How Many More Annas Must Die?
It’s been over a year since my older sister Anna died, so I choke up less readily while speaking about it.  The raw anger is less, but the frustration of losing someone to a preventable medical mistake will always remain with me.   Anna was five years older than me, my only sister, and the one I often turned to for advice. We were close despite living 600+ miles apart.  She was smart and insightful; she was at ease in most social situations. I, on the other hand, was the nerdy kid sister who loved science, who became a physician in my early 40’s. In 2012, Anna’s world turned upside down when she was diagnosed wit...
Source: Disruptive Women in Health Care - September 29, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Advocacy Policy Publc Health Quality Source Type: blogs

MedPAC Revisits Open Payments; Considers Expanding Reporting Requirements
Discussion 9-11 Slides of MedPac Open Payments Presentation MedPac Commission Members          
Source: Policy and Medicine - September 16, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs

On PVCs, think anew but think slowly
Premature ventricular complexes (PVCs) remain a common and vexing problem in cardiology. PVCs deserve attention because they often induce fear in both patient and doctor. In US healthcare, fear is bad. Fear sets the stage for over-treatment. The approach to the funny-looking beats has not changed much in the last two decades. That may be changing. Cardiology is beginning to see PVCs in a different way. First the current approach: We begin by asking: “What company do the skipped beats keep?” Old teaching had it that PVCs in the setting of a normal heart were benign. Don’t worry about them. Reassure the pat...
Source: Dr John M - August 14, 2015 Category: Cardiology Authors: Dr John Source Type: blogs

Virtual Cardiology Lab
Looking for a supplemental hands-on activity with cardiology in your course?Try the FREE online interactive Cardiology Virtual Lab from the Howard Hughes Medical Institute.It covers these concepts:Symptoms of a selection of heart diseases, to serve as examples of what kinds of things can go wrong with the heart. How are symptoms detected and why?Tools and techniques used for diagnosis. What can the different techniques detect and how do they work?Principles of pedigree analysis.What can we use from this in teaching undergraduate A&P?Link to this virtual lab activity from your online s...
Source: The A and P Professor - June 15, 2015 Category: Physiology Authors: Kevin Patton Source Type: blogs

CMS Releases 2013 Medicare Payment Data for Hospitals and Physicians
  Yesterday, the Centers for Medicare and Medicaid Services (CMS) announced the release of utilization and payment data for both Medicare hospital services (inpatient and outpatient) and for physicians and suppliers. This is the third year the hospital data was released and the second year that the physician and supplier data was released. Indeed, the big troves of healthcare data keep coming. On April 30, CMS published information on 2013 Medicare Part D payments. At the end of this month, on June 30, CMS is scheduled to release the first full year of pharmaceutical and medical device trans...
Source: Policy and Medicine - June 2, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs

LITFL Review 183
Welcome to the 183rd LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week  The Emergency Medicine Educator’s Conference (EMEC) posted the first of its conference videos. Dan Boden shares Derby’s ideas and success on teaching the whole department. Plenty of food for thought….. [SL]   The Best of #FOAMed Emer...
Source: Life in the Fast Lane - May 24, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Access, Excess, And Medical Transformation: Delivering Durable Health Care In Rural Nepal
Conclusion: On Impact And Scale We believe that Durable Healthcare can transform the health care industry away from the dominant fee-for-service paradigm and towards a model that incentivizes patient safety, patient-centeredness, and evidence-based medicine. Only then we will have a competitive marketplace of private sector providers who leverage public funds for the broader public good.
Source: Health Affairs Blog - May 21, 2015 Category: Health Management Authors: Duncan Maru and Padam Chand Tags: Global Health Innovations in Care Delivery Organization and Delivery Population Health Public Health ACOs Durable Healthcare Organization EMR health technology Nepal health care Possible triple aim Source Type: blogs