The inaugural Grand Rounds

Blogborygmi is organizing the first Grand Rounds to be posted next Tuesday, 9/28. Read more about it, and find out how you can contribute.

No surprise here

After many instances of media misinterpretation of cancer screening, comes this poignant study.

Morphine in hospice care

An article in Cancer suggests that too little morphine is used in hospice care. As was discussed previously, alleviation of pain and maximizing comfort is paramount in hospice situations. Interestingly, those who were given larger doses of morphine lived longer.

A new blood test for diabetes? Hmm . . .

New Blood Test Advised for Diabetes Patients“. Quite a headline. This is the media’s interpretation of an article in this week’s Annals of Internal Medicine. This “new” test is in fact, the hemoglobin A1c – which is a standard test in monitoring diabetes control. The title should have been “A new use for an old test”.

The study suggests that cardiovascular (CV) disease …

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Talking about death with dying children

An interesting study in this week’s NEJM on discussing death with children who are terminally ill. The conclusion:

Parents who sense that their child is aware of his or her imminent death more often later regret not having talked with their child than do parents who do not sense this awareness in their child; overall, no parent in this cohort later regretted having talked with his or her …

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An excellent debate . . .

. . . on malpractice reform at PointofLaw. Ironically, we find a physician supporting Kerry, and a lawyer arguing for Bush.

One way to stem the tide . . .

. . . of antibiotic overuse: educate. Almost 1/3 of those surveyed believed a cold or flu should be treated with an antibiotic.

Hospitalists

Medpundit writes about giving in to the hospitalist temptation. Let me say, hospital medicine is a completely different world from primary-care medicine. If you stay away from it, that knowledge will slowly dissipate. It’s like not exercising a muscle – after awhile, it will atrophy and weaken. That’s partly why I enjoy the occasional hospital and ER shifts – keeping these skills sharp is important …

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The eyes . . .

. . . have it (via Psych Central).

B-natriuretic peptide

One of the more helpful tests that I’ve used recently in the past few years or so is the B-natriuretic peptide (BNP). It recently came up in a story I was reading.

I was reminded of how useful the test was during a recent emergency room shift. In those presenting with shortness of breath, one has to decide whether the cause is the lungs (pneumonia, COPD, …

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Counterpoint to . . .

. . . pro-Canada and reflecting the controversy and difficulty in finding a solution, this editorial gives reasons why the Canadian way isn’t better.

Pro-Canada

With recent discussion on Canada vs US-style health care, commentary from the Washington Times takes a pro-Canada, pro-Kerry stance as a solution to our system.

Good point

One reason why improving our health-care system is so difficult:

However, there’s another reason why Washington is reluctant to attempt major surgery: For the 158 million or so Americans who are covered by private health insurance, the system works reasonably well and doesn’t need fixing.

Despite all the talk of health-care system failures and the growing number of people who have no health insurance, polls consistently show that Americans …

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The Concord Monitor . . .

. . . with a pair of editorials: one detailing some of the issues plaguing our health-care system, including “shell-game” of re-distributing health-care costs:

Costs are shifted “from the payer to the patient, from the health plan to the hospital, from the hospital to the physician, from the insured to the uninsured and so on.

Passing costs from one player to another, like a hot potato, creates no net …

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Power of placebos

It seems that health care providers in Israel gave placebos instead of real medication 60 percent of the time. Of these people, 68 percent misled the patient about the drug they were given.

The grass is always greener . . .

It seems like Americans and Canadians want each other’s health care system. Improved access for Canadians. Universal coverage for Americans. Medpundit weighs in earlier this week. Dr. Centor gets to the root of the problem:

Health care costs are increasing everywhere because we can do so much more than we could 10 years ago. Our diagnostic tests have improved – but at increased cost. …

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Screening for ovarian cancer

Ovarian cancer is the leading cause of death from a gynecologic malignancy, and there is continual interest whether the general population should be screened for this disease. A recent report has suggested a new blood test testing for early ovarian cancer. Here’s how the media portrayed this:

BY THE TIME MANY WOMEN FIND OUT THEY HAVE OVARIAN CANCER, IT’S TOO LATE.

THAT’S BECAUSE THERE’S NEVER BEEN A …

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Defibrillators for your home and in time for Christmas

The FDA recently approved a purse-sized defibrillator (AED – automatic external defibrillator) for home use at $2000 each. The company “is already selling the product on its Web site and hopes to have it on stores shelves by Christmas . . . [they] hope the device will become as common as a fire extinguisher or a smoke detector . . . “, and is being advertised as the “Read more…

Brain scans and Alzheimer’s dementia

In reading this morning’s headlines, several caught my eye: “Medicare will pay for Alzheimer’s scan” and “US to pay for brain scans to diagnose Alzheimer’s”. The funny thing is, the diagnosis of Alzheimer’s dementia is not based on any imaging nor laboratory tests. 87 percent of cases can be detected clinically in the absence of blood tests or scans. So, what is the role of imaging in Alzheimer’s dementia?

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Emergence of medbloggers

Jon Udell writes about the emergence of medbloggers, talking about this blog, the invaluable Medlogs, as well as two of the most respected and established medical blogs – Medpundit and DB’s Medical Rants:

From the get-go, I knew that blogging was bound to disrupt information monopolies not only in IT and politics, but in other realms too. Now it appears that the medical blogosphere, something I’ve long …

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