It is well known that Medicare expenditures threaten the financial solvency of the U.S. government. And it is pretty well agreed upon that some of our Medicare spending goes towards wasteful medical care. But which medical care is wasteful and how much is such care costing us?  A study in JAMA Internal Medicine provides a sneak peek at answers to these important questions. The research, led by Aaron Schwartz, a graduate student ...

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I walk out of the patient room.  My eyes stare at the computer screen.  I’m behind, way behind.  I roll my head on my neck.  My neck feels tense, and I have a headache.  It’s been a long week.  I need a vacation.  Hurry up, click-click-click this computer, I think to myself.  Dammit, is this EMR really freezing up again? I look up.  A man walks out of a patient room ...

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Top stories in health and medicine, November 26, 2014From MedPage Today:

  1. USPSTF: Routine Vitamin D Screening Unsupported. There is not enough evidence that vitamin D screening is beneficial in routine practice and therefore it can't be recommended, according to the U.S. Preventive Services Task Force.
  2. SLE Patients See Good Outcomes in Blood Cancers. Risk of hematologic malignancy may be increased ...

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We need to start skin cancer prevention with our children The numbers about skin cancer incidence and costs in the United States are worse than anyone expected. That's the message that comes from a report published recently in the American Journal of Preventive Medicine on research from the Centers For Disease Control and Prevention, the Agency for Healthcare Research and Quality and the National Cancer Institute. The researchers took a look at the number of skin cancers ...

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The costs of fertility preservation in cancer treatment I have fertility on my mind -- and it’s definitely not personal. And it’s really fertility preservation that has me thinking. I recently completed the manuscript of my 10th book -- a text for oncology care providers about the provision of psychosocial care to young adults with cancer . Writing the book was at times frustrating due to the paucity of research and ...

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Close to midnight and Tonya is somnolent, lying on an emergency department (ED) stretcher and not in her own bed at home. The change in location alters the fairy tale quality of the word somnolent from sleepy or drowsy to one that's more sinister and worrisome. Especially when Tonya is dying of brain cancer, a single mother of thirty-four, a hospice patient now situated in the ED; a space powered by a ...

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The fact that childhood cancer is, thankfully, a rare disease belies the fact that it is the leading cause of disease-related death in U.S. children, age 1 to 19.  The fact that it is a rare disease also belies the fact the number of people with a direct stake in expanding research into pediatric cancer is quite large and extends well beyond the small number of children with cancer and ...

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Nobody, it seems, is comfortable with death. In Haiti, where death and life are fluid concepts, where voodoo curses and ghosts are spoken of as fact rather than fiction, death is comfortably present. The dead are buried in mass graves throughout the country, victims of political crime, violence, malnourishment and infectious disease. There, life can be drained from a healthy person in a matter of hours for lack of clean ...

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What Mayor Thomas Menino taught us about cancer Beloved and deeply respected Boston mayor Thomas M. Menino died on hospice in Brigham and Women’s Hospital recently.  Menino developed advanced cancer of unknown primary (CUP) in the spring of this year, and after six months of chemotherapy, he elected to stop active treatment.  Reportedly he was comfortable, and surrounded by friends and family at the time of his death.  The press, the ...

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Mrs. C was used to my quiet knock every morning at 6 a.m. She smiled as I turned on the overhead lights, but began to grimace when she realized that today was dressing-change day. The rustling packages of bandages in my overstuffed coat pockets had given it away. Mrs. C had stage four metastatic endometrial cancer; a malignancy of her uterus that was not responding well to chemotherapy and had ...

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