. . . allowing those to comparison shop for prescription medication is proving to be quite popular in New York state.
I have an extra half-hour this morning before I see patients, so here are some interesting stories to start your day.
Despite tort reform, some physicians are leaving high-risk practice.
An article on people who steal physician identities.
I do some work at the VA, so I see first-hand many of the primary care physician shortages (6+ month wait in some cases). With a …
Today’s Annals of Internal Medicine reports a study suggesting that colonoscopies may be overdone. This story was picked up by the lay press.
With regards to hyperplastic polyps, the guidelines are unclear. Here is what UptoDate says:
At the present time, there is no clear consensus regarding what recommendations should be given to asymptomatic patients at average risk for CRC who are found to …
Interesting study – most patients seem to want their physicians to wear white coats:
In contrast to doctors, who view white coats as an infection risk, most patients, and especially those older than 70 years, feel that doctors should wear them for easy identification. Further studies are needed to assess whether this affects patients’ perceived quality of care and whether patient education will alter this view.
I find wearing …
In my home state, where motercyclists can ride without helmets, New Hampshire is becoming one of the last states to ban smoking in restaurants. Tough to be a public health officer here when you do not have the support of the state. As one such officer puts it: “New Hampshire is becoming the ashtray of New England”.
The New England Journal published a sounding board piece on the future of primary care in the United States. The authors suggest that one paradoxical reason is the increased exposure to primary care in residency training:
But an additional possibility, albeit an apparently paradoxical one, is that the decline is due in part to the successful efforts by medical schools to increase students’ exposure to primary care practice. …
While I was on vacation, the DEA released guidelines “designed to help doctors prescribe narcotics like Oxycontin and morphine without fear of arrest”.
A recent study suggests that a single IM dose of steroid is equivalent as an 8-day tapering course of oral steroid in the setting of relapse rates from acute asthma attacks:
Objective: To compare the efficacy of long-acting IM methylprednisolone to tapering oral methylprednisolone in adult asthmatic patients discharged from the emergency department (ED).
Methods: Randomized, double-blind, placebo-controlled trial of a single IM dose of 160 mg depot …
. . . from a wonderful vacation and ready to work. Forums will be open later today, and I’ll slowly answer my email.
I went to lovely St. Martin, the culinary capital of the Caribbean. The small fishing village of Grand Case hosts an unbelievable array of fantastic dining – and it surely did not disappoint. Highly recommended to any gourmet …
. . . while I’m gone:
The dangers of medical advisory board scams.
A poignant story, entitled “It’s not just what we say.”
Another story on the rewards of medicine.
A new addition to the Scutmonkey Comics.
Medrants discusses the levels of thinking …
. . . and without internet access. Apologies in advance if I don’t respond to emails. Regular blogging will continue when I return and my forums will reopen on August 14th.
The RALES study, published in 1999, concluded that spironolactone reduce mortality in those with severe heart failure (i.e. Class IV failure). Today’s NEJM comes out with a study showing that due to the RALES study, rates of hyperkalemia and mortality from this complication increased. Taking this into account, there were no significant decreases in death from all causes.
The reason for this is that most …
A few weeks ago, one of my colleague’s sister from Ireland came over for a visit. The wait for a screening mammogram there was 6 months. She decided to pay out of pocket to have one here. It was booked for her the next day. However, in some parts of the country, the wait times are growing.
. . . that triptans do not increase the rate of heart attack and stroke. Reassuring for migraine sufferers.
. . . as to what happened to this unfortunate boy? A previously-healthy 13-year old was hiking and saw a bear in the woods. After running away, he went into respiratory distress and collapsed. Would it be possible for the catecholamine release to trigger some sort of arrhythmia?
. . . the inaction of tort reform, two towns in Illinois are taking matters into their own hands.
Other than erectile dysfunction, Viagra has been studied in the treatment of pulmonary hypertension. Today’s Annals of Internal Medicine presents a small study showing Viagra increased exercise capacity both in normal and high altitudes, suggesting a possible use in managing acute mountain sickness or other conditions caused by low oxygen levels at the alveoli.
As I have been continually telling my patients, antioxidant supplements do not have the appropriate evidence to support their use. Today, the American Heart Association agreed.
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