Conditions

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 …

Read more…

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 …

Read more…

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 …

Read more…

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 …

Read more…

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, …

Read more…

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 …

Read more…

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 …

Read more…

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 …

Read more…

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 …

Read more…

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 …

Read more…

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 …

Read more…

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 …

Read more…

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 …

Read more…

5 diabetes posts you may have missed

With entries dating back to 2004, here are 5 classic blog posts on diabetes:

1. Does Avandia cause heart attacks, and why the RECORD study is important

2. Will diabetes derail Sonia Sotomayor’s chance to become a Supreme Court justice?

3. Prescribing insulin for diabetes, do endocrinologists have a financial incentive to do so?

4. Are Actos and Avandia to blame for rising diabetes costs?

5. Prescription medication pay for …

Read more…

How soon should patients receive their test results?

And should you assume that no news is good news?

The answer is no. According to a study in the Archives of Internal Medicine, 7 percent of abnormal test results from primary care offices were never reported to the patient. And in a large, unnamed, academic medical center, that number ballooned to 23 percent.

That’s almost a quarter of abnormal test results from that center that patients were never …

Read more…

Prostate cancer screening in blacks, and the lack of balanced information

Prostate cancer screening continues to be a controversial issue.

Regular readers of this blog know about the risks of cancer screening, especially prostate cancer, which can lead to unnecessary biopsies necessitating invasive procedures that can lead to life-altering side effects. All for a slow-growing cancer that may not have led to death.

The problem with prostate cancer is that the current detection methods, like the prostate specific antigen, are not …

Read more…

Should patients care how many times a doctor has performed chorionic villus sampling?

When it comes to procedures, experience counts.

In a recent op-ed in the WSJ, maternal-fetal medicine fellow Adam Wolfberg talks about the potential complications of chorionic villus sampling (CVS) (via Suture for a Living). Used to assess the risk of Down Syndrome in the fetus, it involves inserting a 3 1/2 inch needle into the mother’s uterus to obtain cells from the placenta. The rate of miscarriage is …

Read more…

Should Steve Jobs talk more openly about his pancreatic cancer?

As you have read here and elsewhere, Apple’s Steve Jobs recently underwent a liver transplant for a rare form of pancreatic cancer.

He, however, is not talking publicly about his case, and Apple is tightly controlling the information surrounding Mr. Jobs’ health.

Certainly, he is entitled to his medical privacy, but there are some who believe he should use his stature and celebrity to raise the awareness of pancreatic cancer. …

Read more…

Why did Michael Jackson have a heart attack, and CPR by Dr. Conrad Murray

Michael Jackson suffered a cardiac arrest. And still, that’s really all we know for sure.

Medical websites continue to speculate on the possible causes. Over at theheart.org, doctors who were interviewed continue to speculate on Jackson’s narcotic use, including Demerol, which I wrote about a few days ago. Indeed, a spokesperson for the American College of Cardiology, cardiologist …

Read more…

222
pages

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories