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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Ignoring advice

NBC News recently did a story on why patients ignored their doctor’s advice. The most glaring example of this was Clinton’s failure to take a statin with an LDL of 177. Here are some excerpts:

Andrew Mahoney, Jr., a 43-year-old father of three, learned from his doctor that he had high cholesterol and should take a statin drug. He filled the prescription, but usually neglected to take the …

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Can’t get enough

More on screening MRIs for breast cancer. JAMA released a study examining screening MRIs for patients with the BRCA1 and BRCA2 gene mutation (those who have this mutation have an 85 percent lifetime risk of developing breast cancer):

“This study of 236 BRCA1 and BRCA2 mutation carriers demonstrates that the addition of annual MRI and ultrasound to mammography and CBE significantly improves the sensitivity of surveillance for detecting …

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Cheers

I don’t often give the mainstream media many kudos when reporting medical news, but I’m happy to see MSNBC highlighting the appropriate context of a screening MRI for breast cancer. The story even made the MSNBC home page. Echoing what was written here, MSNBC reports:

If you’re not at high risk for breast cancer, make sure you get a yearly mammogram. But at this point, MRI is not …

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The hidden cost of medications

From the Archives of Internal Medicine, comes this story:

About one-third of chronically ill adults who underuse medications because of the costs associated with buying the drugs, never tell their health care practitioners . . .

The underuse of essential medications, including cholesterol-lowering medications, heart medications, asthma medications and antipsychotics, has been associated with increased emergency department visits, nursing home admissions, acute psychiatric hospitalizations, and a decrease in self-reported …

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Screening for breast cancer

In a good news/bad news kind of article, it suggested that most women are receiving their mammograms by the age of 40, but aren’t following-up as suggested:

A new study finds most women now follow the recommendation to receive their first screening mammogram at age 40, but there is widespread failure to return promptly for subsequent exams and several sub-populations of women still are not being screened by the …

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Mainstream

Some journalism blogs, like Micro Persuasion and Jim Grisanzio, have picked up last week’s profile in the Telegraph. Jim expresses one of the major reasons why this blog exists:

The information the docs were offering was complex and many times serious. Trivializing it could have profound implications. It needed more time to be explained and understood than the 60 second special report on the news with dramatic music and …

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Active euthanasia

What an incredible story today from Medpundit:

An elderly, “comfort care only” patient was transferred from her nursing home to the ER in the middle of the night because the nursing home didn’t know what to do when she developed abdominal pain. She was much too frail to withstand surgery, and since she was “comfort care only,” that wasn’t an option anyways. The emergency room doctor who drew her …

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Saturday news rounds

A view of the Kerry and Bush health plans from overseas.

As much as I harp on problems with our health care system, Canada’s health system has its own issues to deal with.

I’m a generalist, and I’m singing.

With the wealth of medical internet sites, is it time for an “information prescription“?

The effects of smoking is worse that we tought: one-half …

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"Clinton syndrome" and heart disease

With focus on the former president’s successful heart surgery, there is more interest than ever in screening for heart disease. Lots of business for hospitals:

“I’d imagine that the phones are ringing off the hook at every cardiology practice in the city,” said Dr. Peter Buttrick, cardiology chief at the University of Illinois Medical Center. “There certainly is more public awareness of heart disease this week than there was …

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PSA and prostate cancer screening

So I read this catchy headline today: “Prostate test ‘all but useless'”:

The team studied prostate tissues collected over 20 years, from the time it first became standard to remove prostates in response to high PSA levels. Thomas Stamey, who led the research, said they concluded that the test indicated nothing more than the size of the prostate gland. “Our study raises a very serious question of whether a man …

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ER thoughts: John Ritter, lawsuits, and the aortic dissection

I just completed another shift in the emergency room (which I do about once per month), and it continually amazes me the amount of non-emergent cases that comes through – but that’s for another rant.

So I’m reading that the family of John Ritter is suing the hospital for misdiagnosing his ascending aortic aneurysm. Galen certainly has some tough words for this. I’ll reserve opinion since I’m …

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Response to Columbia-Presbyterian’s "death rate"

Dr. Au gives her typically hilarious, off-the-cuff response to the laughably ignorant NY Times piece on the cardiac surgery death rate at Columbia-Presbyterian.

Rising health premiums

Attention again is focused today on rising health premiums. Some quotes from the article:

Health care costs continued to surge this year as family premiums in employer-sponsored plans jumped 11.2 percent, the fourth year of double-digit growth, according to a new study.

The cumulative effect of rising health care costs is taking a toll on workers: There are at least 5 million fewer jobs providing health insurance in 2004 …

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Hostages in the ER

In a reminder that an emergency room can be dangerous place, this story reveals how desperate some patients are to continue their prescription drug abuse:

A man apparently distraught at not being able to see a doctor immediately held two hostages for 20 minutes at Frisbie Memorial Hospital Wednesday. . .

“They were able to get a doctor to respond to the emergency room,” Officer Mike Allen said. …

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