Conditions

Will the spread of swine flu be affected by the uninsured?

By now, we’re aware of the sobering predictions for this fall’s spread of H1N1 influenza.

But, as the Washington Post’s Ezra Klein points out, our health system is ill-suited to deal with the situation:

It’s simply too fractured to do anything different. Almost 50 million Americans have no insurance. Many more are underinsured. Many don’t have a particular doctor or even medical center where they feel comfortable receiving care. Many are …

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Why following a delayed vaccine schedule may be dangerous

by Steve Perry, MD

I recently read a post by Dr. Bob Sears which listed several “Vaccine Friendly Doctors” in Colorado and across the nation.

As a pediatrician and vaccine advocate, I thought I’d be on this list. I am “vaccine-friendly doctor” who works with moms and dads to find the best health care plan for their babies. I read the information on both sides of the issue and weighed the science …

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Increasing radiation exposure to patients from CT scans and other imaging tests

by Kristina Fiore, Staff Writer, MedPage Today

Imaging procedures can expose patients to high cumulative doses of radiation, researchers say.

medpage-today In a large study, 193.8 people per 1,000 were exposed to moderate doses of radiation each year, while 18.6 per 1,000 were exposed to high doses, and 1.9 per 1,000 received very high doses, according to Reza Fazel, MD, of …

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New troponin tests to better diagnose a heart attack

by Crystal Phend, Senior Staff Writer, MedPage Today

A generation of new, more sensitive troponin assays has improved hospitals’ ability to diagnose a heart attack to a point as early as the time of emergency department presentation, two separate studies affirmed.

medpage-today1 In one multicenter study, a sensitive troponin I assay had an early diagnostic accuracy of 96%, compared with conventional …

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Treating Fournier gangrene, or necrotizing fasciitis of the male genitals

Fournier gangrene one of the nastiest infections you’ll ever see.

General surgeon Jeffery Parks details a case, complete with a vivid CT scan:

fournier-gangrene

Dr. Parks takes us behind the scenes in treating the condition, which requires rapid surgical debridement. “There’s nothing fancy about this surgery,” he writes. “You cut and debride until all the necrotic fat and skin and muscle …

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Is Caster Semenya a woman, and the issues surrounding androgen insensitivity syndrome

Caster Semenya is the South African track and field star who recently was engulfed in controversy at the recently concluded World Track and Field Championships.

caster-semenya Turns out, there are some who are questioning her gender, and subsequently, tests are being conducted to see if she is really a woman.

It’s not as cut and dry as it appears.

Consider the possibility of Read more…

Michael Jackson dead from propofol, is Dr. Conrad Murray solely to blame?

Recent reports have said that Michael Jackson died from a propofol overdose. Is that really the case?

Here’s what happened, according to the published timeline.

— At about 1:30 a.m., [Dr. Conrad] Murray gave Jackson 10 mg of Valium.
— At about 2 a.m., he injected Jackson with 2 mg of the anti-anxiety drug Ativan.
— At about 3 a.m., Murray then administered 2 mg of the sedative Versed.
— At about 5 …

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Did the oral polio vaccine cause an outbreak in Nigeria?

by Matthew Bowdish, MD

The World Health Organization (WHO) reports that approximately 180 Nigerian children have become paralyzed by polio as a result of widespread vaccination efforts in Africa’s most populous country. The outbreak is from the use of an oral polio vaccine (OPV) that contains a live-attenuated form of the poliovirus.

OPV was initially developed by Albert Sabin in the 1950s. A live-attenuated poliovirus vaccine is ingested and stimulates …

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Do patients really need their complete lab and radiology reports?

Most prefer the bottom line, sparing them the raw data.

Primary care physician Rob Lamberts asks that exact question, and reprints sample reports of lab tests and an echocardiogram, demonstrating the wealth of information they contain.

So, borrowing this image from Dr. Rob, I’m not sure how useful something like this would be to patients (sorry for the small type, but you get the idea):

lab-values

Health care policy experts versus the public, an obstacle to reform

I’ve often written that the public’s appetite for excessive medical testing is difficult to overcome.

Kent Bottles finds the same thing. Indeed, he writes that, ” One of the obstacles to achieving health care reform is the enormous gap between what the health care experts believe and what the general public believe about staying healthy.”

For instance, according to the Kaiser Family Foundation, “the experts believe that 30% of care is …

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Do lacrosse players have a higher rate of sudden cardiac death?

Surprisingly, lacrosse is the fasting growing youth sport in the country.

MedPage Today reports a recent study from Pediatrics that showed that lacrosse players have a disproportionally higher rate of commotio cordis, which is ventricular fibrillation caused by blunt chest trauma.

43 percent of lacrosse deaths can be attributed to the condition, compared to 27 percent in hockey, and 24 percent in baseball.

What to do? Researchers are looking at …

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KevinMD health reform Virtual Town Hall: Thursday, August 13th at 12:15pm Eastern

In the spirit of the vigorous town hall meetings across the country discussing health care reform, I’ll be taking your questions on the topic today at 12:15pm Eastern.

I’ll open up the forum a few hours before; just click on the Live Q&A window below.

You can ask your question when the Q&A opens, in the comments of this post, or Tweet them to #kevinmdqa. I’ll try, but cannot guarantee, …

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Can you escape a family history of heart disease?

With the new treatments and medications available to treat heart disease, it sometimes appears that a strong family history of heart disease can be overcome.

That’s not always the case.

In this piece from The New York Times, Michael Winerip does all the right things, including exercising, closely following up with a cardiologist, and undergoing stress tests and angiograms, but still was diagnosed with significant heart disease at the same of …

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Has Wikipedia ruined the Rorschach test?

A physician recently uploaded 10 of the original Rorschach plates to Wikipedia, and psychologists are angry about it.

rorschach The Rorschach test is commonly used by psychologists to assess personality and emotional responses. By uploading the images, as well as common responses, they fear that patients can “game” the test, and in effect, render the results useless.

They say that, “the …

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Cheap asthma treatment using a homemade spacer

Do homemade spacers for asthma work?

Take a look at how WhiteCoat “MacGyvered” a spacer for a metered dose inhaler, which can cost up to $100. So, instead of this:

spacer

You get this:

spacer-device

Brilliant.

While keeping in mind that this blog does not give medical advice, consider a study from The Lancet that compared …

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Will Americans accept a trade-off in medical accuracy for lower costs?

With so much focus on health care costs, it’s important to consider the mindset of the American patient.

The Wall Street Journal asks whether simple, less expensive, health care strategies that work in developing countries can be implemented Stateside.

For example an AIDS clinic in Alabama, by mimicking a similar program in Zambia, decreased its no-show rates by giving prompt appointments and interviewing patients looking for reasons why they may not …

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Should heart disease screening tests be covered by insurance?

Tremendous controversy surrounds the screening for cardiac disease.

The USPSTF does not recommend heart screening tests for the general population, like a routine EKG or exercise stress test. Texas, however, takes the opposite approach. They recently passed the Texas Heart Attack Prevention Bill (via Schwitzer), “mandating health-benefit plans to provide coverage for certain screening tests for early coronary artery disease.”

Indeed, some of the wording of the bill endorses tests …

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E-cigarettes are not safe, and here’s why

E-cigarettes, or electronic cigarettes, have been largely unregulated, and there have been many doctors questioning its safety.

MedPage Today recently reported on the FDA’s analysis of such products, and now we have some guidance as to how dangerous they can be.

E-cigarettes are battery operated, and contain nicotine and other flavors that the user can inhale. Advertisements claim they are safer since they don’t burn tobacco.

But according to the FDA, they …

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Are we finding too much breast cancer?

Breast cancer screening has lead to an over-diagnosis of breast cancer.

Ramona Bates talks about a recent study in the BMJ, showing that there was a “52% over diagnosis of breast cancer in a populations of women who are offered organized mammography screening,” amounting to, “one in three breast cancers being over diagnosed.”

When it comes to cancer screening, it’s hard to accept the consequences of over-diagnosis. But that risk …

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How to find an endocrinologist for your diabetes

A lot of time and effort needs to be spent finding the right patient-physician match. And no where is that more relevant than a diabetic looking for an endocrinologist.

Diabetes blogger Amy Tenderich gives some great tips, most of which I hadn’t thought of.

Of course, it goes without saying that if the match isn’t right, a second or third opinion is always within a patient’s right.

But, how do you know …

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